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HomeMy WebLinkAbout05-6393N Commonwealth of Pennsylvania County of Cumberland WRIT OF SUMMONS JANET ARONSON, ADMINISTRATRIX OF THE ESTATE OF STEPHEN J ARONSON, DECEASED 34 GREENMONT DRIVE ENOLA, PA 17025 Plaintiff Vs. BARBARA A. LITTLE, N.P. 1740 TOWPATH ROAD DAUPHIN, PA 17018 AND THOMAS W. ALDOUS, M.D. 503 N. 21sT STREET CAMP HILL, PA 17011 AND DIALYSIS CORPORATION OF AMERICA 27 MILLER STREET LEMOYNE, PA 17043 Defendant Court of Common Pleas No. 05-6393 CIVIL TERM In CivilAction-Law To BARBARA A. LITTLE, N.P., AND THOMAS W. ALDOUS, M.D. AND DIALYSIS CORPORATION OF AMERICA, You are hereby notified that JANET ARONSON, ADMINISTRATRIX OF THE ESTATE OF STEPHEN J. ARONSON, DECEASED, the Plaintiff has / have commenced an action in Civil Action-Law against you which you are required to defend or a default judgment may be entered against you. (SEAL) Date DECEMBER 15, 2005 ?? Pro onotar By -. Deputy Attorney: Name: AARON J. FRIEWALD, ESQUIRE Address: LAYSER & FREIWALD, P.C. 1500 WALNUT STREET, 18Tn FLOOR PHILADELPHIA, PA 19102 Attorney for: Plaintiff Telephone: 215-875-8000 Supreme Court ID No. 78028 ?`-' ?? =`- LAYSER & FREIWALD, P.C. By: Aaron J. Freiwald, Esquire a'fala serfreiwald.com Attorney I.D. No. 78028 1500 Walnut Street, 18" Floor Philadelphia, PA 19102 (215) 875-8000 JANET ARONSON, Administratrix of the Estate of STEPHEN J. ARONSON, deceased Plaintiffs, V. BARBARA A. LITTLE, N.P, et al. Defendants Attorney for Plaintiffs COURT OF COMMON PLEAS OF CUMBERLAND COUNTY NO.: 05-6393 CERTIFICATE OF MERIT AS TO DEFENDANT DIALYSIS CORPORATION OF AMERICA I, Aaron J. Freiwald, Esq., certify that: ® an appropriate licensed professional has supplied a written statement to the undersigned that there -;s a basis to conclude that the care, skill or knowledge exercised or exhibited by this defendant in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional standards and that such conduct was a cause in bringing about the harm; OR ® the claim that this defendant deviated from an acceptable professional standard is based solely on allegations that other licensed professionals from whom this defendant is responsible deviated from an acceptable professional standard and an appropriate licensed professional has supplied a written statement to the undersigned that there is a basis to conclude that the care, skill or knowledge exercised or exhibited by the other licensed professionals in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional standards and that such conduct was a cause in bringing about the harm; OR ? expert testimony of an appropriate licensed professional is unnecessary for prosecution of the claim against the defendant. Date: OL?Lv aAj\,N AARON J. FREIWALD, Esquire Attorney for Plaintiffs :;? ?- ... 9., =?. 9? Vt, ., ?? 1 LAYSER & FREIWALD, P.C. By: Aaron J. Freiwald, Esquire ai fA-lavserfreiw ald. corn Attorney I.D. No. 78028 1500 Walnut Street, 18" Floor Philadelphia, PA 19102 (215) 875-8000 JANET ARONSON, Administratrix of the Estate of STEPHEN J. ARONSON, deceased Plaintiffs, V. BARBARA A. LITTLE, N.P, et al. Defendants Attorney for Plaintiffs COURT OF COMMON PLEAS OF CUMBERLAND COUNTY NO.: 05-6393 CERTIFICATE OF MERIT AS TO DEFENDANT BARBARA A. LITTLE, N.P. I, Aaron J. Freiwald, Esquire, certify that: ® an appropriate licensed professional has supplied a written statement to the undersigned that there is a basis to conclude that the care, skill or knowledge exercised or exhibited by this defendant in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional standards and that such conduct was a cause in bringing about the harm; OR ? the claim that this defendant deviated from an acceptable professional standard is based solelyon allegations that other licensed professionals forwhom this defendant is responsible deviated from an acceptable professional standard and an appropriate licensed professional has supplied a written statement to the undersigned that there is a basis to conclude that the care, skill or knowledge exercised or exhibited by the other licensed professionals in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional standards and that such conduct was a cause in bringing about the harm; OR ? expert testimony of an appropriate licensed professional is unnecessary for prosecution of the claim against the defendant. Dated: \1?L'lIl?1? LAYSER & FREIWALD, P.C. AARON J. FREIWALD, ESQUIRE Attorney for Plaintiffs ?' i ?,??, d?k' rrlr? o s LAYSER & FREIWALD, P.C. By: Aaron J. Freiwald, Esquire aifAI ayserfreiwald. com Attorney I.D. No. 78028 1500 Walnut Street, 18°i Floor Philadelphia, PA 19102 (215) 875-8000 JANET ARONSON, Administratrix of the Estate of STEPHEN J. ARONSON, deceased Plaintiffs, V. BARBARA A. LITTLE, N.P, et al. Defendants Attorney for Plaintiffs COURT OF COMMON PLEAS OF CUMBERLAND COUNTY NO.: 05-6393 CERTIFICATE OF MERIT AS TO DEFENDANT THOMAS W. ALDOUS. M.D. I, Aaron J. Freiwald, Esquire, certify that: ® an appropriate licensed professional has supplied a written statement to the undersigned that there is a basis to conclude that the care, skill or knowledge exercised or exhibited by this defendant in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional standards and that such conduct was a cause in bringing about the harm; OR ? the claim that this defendant deviated from an acceptable professional standard is based solely on allegations that other licensed professionals for whom this defendant is responsible deviated from an acceptable professional standard and an appropriate licensed professional has supplied a written statement to the undersigned that there is a basis to conclude that the care, skill or knowledge exercised or exhibited by the other licensed professionals in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional standards and that such conduct was a cause in bringing about the harm; OR ? expert testimony of an appropriate licensed professional is unnecessary for prosecution of the claim against the defendant. Dated: 17?1 n l b - LAYSER & FREIWALD, P.C. AARON J. FREIWALD, ESQUIRE Attorney for Plaintiffs C7 ??' r? <:-: ? rti _i ,.. ? c"i -i r.? Tm C, _ - .,J jai -n ; { ° - : .. L? FOULKROD ELLIS Professional Corporation 2010 Market Street Camp Hill, PA 17011 Phone: (717) 909-7006 Attorney for Defendant: Fax: (717) 909-6955 Barbara A. Little. N.P. JANET ARONSON, as Administratrix of the : IN THE COURT OF COMMON PLEAS Estate of STEPHEN J. ARONSON, : CUMBERLAND COUNTY, PENNSYLVANIA Deceased, Plaintiff NO. 05-6393 V. CIVIL ACTION - LAW BARBARA A. LITTLE, N.P., THOMAS W. ALDOUS, M.D. and DIALYSIS CORPORATION OF AMERICA, Defendants JURY TRIAL, DEMANDED PRAECIPE FOR ENTRY OF APPEARANCE TO: PROTHONOTARY Kindly enter our appearance as counsel on behalf of Barbara A. Little, N.P. in the above- captioned matter. FOULKROD ELLIS PROFESSIONAL CORPORATION By. Andrew H. Foul kro , Esquire Attorney I.D. No. 77394 Michael C. Mongiello, Esquire Attorney I.D. No. 87532 Date: December 28, 2005 I, Cheryl A. Garofalo, an employee of the law firm of Foulkrod Ellis, P.C., hereby certify that a true/ an(? Acorrect copy of the foregoing document was served upon all counsel of record this - V?-- -__- day of December, 2005, by depositing said copy in the United States Mail at Camp Hill, Pennsylvania, postage prepaid, first class delivery, and addressed as follows: Aaron J. Freiwald, Esquire Layser & Freiwald, P.C. 1500 Walnut Street, 18th Floor Philadelphia, PA 19102 Attorney for Plaintiff Dialysis Corporation of America 27 Miller Street Lemoyne, PA 17043 Thomas W. Aldous, M.D. 503 N. 21' Street Camp Hill, PA 17011 FOULKROD ELLIS By: PROFESSIONAL CORPORATION C"J N s Y C- .i--s -fi .? _, _, ' i^ Iii -;-: ?. '? . ~.'] LAYSER & FREIWALD, P.C. By: Aaron J. Freiwald, Esquire aif 2lavserfreiwald.com Attorney I.D. No. 78028 1500 Walnut Street, 18" Floor Philadelphia, PA 19102 (215) 875-8000 JANET ARONSON, Administratrix of the Estate of STEPHEN J. ARONSON, deceased 34 Greenmont Drive Enola, PA 17025, Plaintiffs, v. BARBARA A. LITTLE, N.P. 1740 Towpath Road Dauphin, PA 17018 and THOMAS W. ALDOUS, M.D. 503 N. 21st Street Camp Hill, PA 17011 and Attorney for Plaintiffs COURT OF COMMON PLEAS OF CUMBERLAND COUNTY NO.: 05-6393 JURY TRIAL DEMANDED CIVIL ACTION - COMPLAINT [MEDICAL MALPRACTICE 2M] NOTICE You have been sued in court If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this complaint and notice are served, by entering a written appearance personally or by attorney and filing in writing with the court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by the court without further notice for any money claimed in the complaint or for any other claim or relief requested by the plaintiff. You may lose money or property or other rights important to you. You should take this paper to your lawyer at once. If you do not have a lawyer or cannot afford one, go to or telephone the office set forth below to rind out where you can get legal help. Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 717-249-3166 AVISO Le ban demandado a usted on la cone. St usted quiere defenderse de estas demandas expuestas en las paginas siguientes, useted tiene veime (20) dial de plazo al partir de Is fecha de la demands y la notification. Hace flats, asentar una comparencia escrita o en persona o con on abogado y ennegar a la come en forma escrita sus defenses o sus objeciones a ]as demandas en contra de so persona. Sea avisado que si usted no se defiende, la torte tomara medidas y puede cominuar la demanda en contra suya sin previo aviso o notification. Ademas, la puede decidir a favor del demandante y requiere que usted cumpla con todas las provisioner de cant demanda. Usted pwde perer dinero o sus propiedades u ostros derechos import roes para usted. Lieve esta demanda a un abogado inmediatamente. Si no done abogado o si no tiene, el dinero suriciente de pagar tal servicio. Vaya on persona o llame per telefono a la oricina cuya direction se encuentra escrita abajo para averiguar donde se puede conseguir asistencia legal. Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 717-249-3166 P DIALYSIS CORPORATION OF AMERICA: 27 Miller Street Lemoyne, PA 17043 Defendants COMPLAINT Plaintiff Janet Aronson is the Administratrix of the ]Estate of Stephen J. Aronson, deceased. 2. Mrs. Aronson is an adult citizen of the Commonwealth of Pennsylvania, residing at 34 Greenmont Drive, Enola, Pennsylvania 17025. Plaintiff's decedent, Stephen J. Aronson, was born on April 11, 1949 and died on February 24, 2004 at age 54. 4. Defendant Barbara A. Little, N.P. ("Nurse Little") is a nurse practitioner, licensed in the Commonwealth of Pennsylvania, who maintained professional offices at 4700 Union Deposit Road, Suite 240, Harrisburg, Pennsylvania 17111. Plaintiff is asserting a professional liability action against this defendant. Defendant Thomas W. Aldous, M.D. ("Dr. Aldous") is a physician, licensed in the Commonwealth of Pennsylvania, who maintained professional offices at Holy Spirit Hospital, at 503 N. 21" Street, Camp Hill, Pennsylvania 17011. Plaintiff is asserting a professional liability action against this defendant. 6. Defendant Dialysis Corporation of America ("Dialysis Corp.") is a corporation or other legal entity, organized and operating under the laws of the Commonwealth of Pennsylvania, that, at all relevant times, owned and operated a facility located at 27 Miller Street, Lemoyne, Pennsylvania 17043. Plaintiff is asserting a professional liability action against this defendant. At all relevant times, Nurse Little was an agent or employee of Hershey Kidney Specialists. 8. At all relevant times, Dr. Aldous was an agent, servant, employee and/or ostensible agents of Holy Spirit Hospital. 9. At all relevant times, defendant Dialysis Corp. acted through the conduct of its employees, including but not limited to physicians, dialysis technicians, nurses and other staff in rendering medical care and treatment to patients such as Stephen Aronson. 10. At all relevant times, all defendants owed a duty of care to Stephen J. Aronson. 11. Each defendant deviated from accepted standards of care, as set forth more particularly below. 12. As a direct result of the negligence of defendants, individually and jointly together, Stephen J. Aronson was caused to suffer serious personal and other injuries, including, ultimately, his death. 13. Plaintiff Stephen J. Aronson had a history of diabetes and kidney failure. 14. In 2003, Mr. Aronson had placed a dialysis shunt in his left arm in anticipation of dialysis. 15. Mr. Aronson underwent his first dialysis treatment on January 24, 2004 at Dialysis Corp., in Lemoyne, Pennsylvania. 16. Mr. Aronson was not seen or evaluated or counseled. by a physician during his time at dialysis on January 24, 2004. 17. On January 26, 2004 at approximately 5:15 p.m., Mr. Aronson presented to the emergency department of Holy Spirit Hospital complaining of shortness of breath lasting several hours. 18. Mr. Aronson also complained on arrival to the emergency department of a diminished level of consciousness and decreased memory for the previous 24 hours, as well as right arm soreness. 19. On triage, it was noted that Mr. Aronson had an elevated temperature to 100.4, blood pressure pf 141155, pulse of 92, respirations of 18, and a puilse ox of only 87 percent on room air. 20. The triage nurse also noted that Mr. Aronson was complaining of difficulty swallowing and of bleeding from the dialysis shunt in his right arm. 21. Dr. Philip Maguire, the attending emergency department physician, evaluated Mr. Aronson at approximately 6:25 p.m. on January 26, 2004 and ordered, among other things, Lasix for Mr. Aronson's shortness of breath. 22. Dr. Maguire ordered an EKG, chest x-ray, IV fluids, blood work and blood cultures. 23. Mr. Aronson's chest x-ray showed evidence of congestive heart failure. 24. Mr. Aronson's EKG showed a normal sinus rhythm. 25. The results of Mr. Aronson's complete blood count (CBC) showed an elevated white count with a marked left shift. 4 >, 26. Mr. Aronson's nephrologist, Dr. Jonathan Diamond was consulted at approximately 8:35 p.m. by telephone, but apparently Dr. Diamond did not come to see his patient in the hospital. 27. No antibiotics were given in the emergency department. 28. Defendant Dr. Aldous also was attending physician in the emergency department at Holy Spirit Hospital on January 26, 2004. 29. Dr. Aldous saw Mr. Aronson in the ER on January 26, 2004. 30. Dr. Aldous was aware of Mr. Aronson's medical history, the complaints that led him to seek emergency medical attention and the treatment he has received in the ER. 31. Dr. Aldous consulted with Dr. Diamond, apparently by telephone. 32. Dr. Aldous did not insist on or arrange for a face-to-face consultation by Dr. Diamond or another appropriate specialist. 33. At approximately 11:00 p.m., Dr. Aldous discharged Mr. Aronson from the ER. 34. Dr. Aldous wrote an "addendum" to Mr. Aronson's medical chart, which proparts to summarize Dr. Aldous' involvement in Mr. Aronson's care and which is dated February 11, 2004. 35. Even though Dr. Aldous' note is dated a significant period of time later, he makes no mention of evaluating Mr. Aronson's dialysis shunt site. 36. Mr. Aronson was discharged to home from the emergency department with instructions to follow up with his scheduled dialysis appointment the following day. 37. On January 27, 2004, Mr. Aronson presented for dialysis at the Dialysis Corp. in Lemoyne. 5 38. During Mr. Aronson's dialysis treatment, a call was received from Dr. Diamond notifying the dialysis center that Mr. Aronson's blood cultures taken the previous evening at Holy Spirit Hospital were positive. 39. Dr. Diamond gave telephone orders for Mr. Aronson to be given Vancomycin and Gentamycin, two antibiotic medications. 40. Dr. Diamond further ordered that Mr. Aronson be given additional Vancomycin at his regularly scheduled dialysis appointment, on January 29, 2004. 41. Nurse Little saw Mr. Aronson at the Dialysis center on January 27, 2004, Nurse Little noted Mr. Aronson to be "very lethargic." 42. Nurse Little communicated with Dr. Diamond by telephone, but did not arrange for Mr. Aronson to be seen by a physician or to be transferred to the hospital. 43. During dialysis on January 27, 2004, blood was drawn for a CBC. 44. Mr. Aronson was not seen or evaluated or counseled by any physician at the dialysis session on January 27, 2004. 45. The results of the CBC from January 27, 2004, were available the following day and revealed a white count of greater than 22,000. 46. The CBC results were sent by telefax on January 28, 2004 to Hershey Kidney Specialists with a request for antibiotic orders. 47. Blood culture results from January 27, 2004 confirmed the culture results from January 26, 2004 at Holy Spirit Hospital, which had showed the presence of bacteria in Mr. Aronson's blood. 6 48. On January 28, 2004, Dr. Andrea Shaer another nephrologist with Hershey Kidney Specialists, communicated orders to defendant Dialysis Corp. that Mr. Aronson be given Vancomycin every other treatment for three weeks and Gentamycin on January 29, 2004 and January 31, 2004. 49. Mr. Aronson returned for dialysis to the Dialysis Corp. on January 29, 2004. 50. During dialysis on January 29, 2004, Mr. Aronson complained of shortness of breath and had a blood pressure of 94 over 50. 51. Per Dr. Shaer's orders, Mr. Aronson was given Gentamycin, but he was not given Vancomycin at the time of dialysis on January 29, 2004. 52. Mr. Aronson was not seen or evaluated or counseled by a physician at the dialysis session on January 29, 2004. 53. On January 29, 2004, Mr. Aronson returned to the emergency department at Holy Spirit Hospital now complaining of memory loss, intermittent shakes, pale skin and feeling like he has "been out of it." 54. In the ER on January 29, 2004, Mr. Aronson was seen by Dr. Amy Fajardo, an attending emergency department physician, whose impression was that Mr. Aronson had altered mental status and hypoglycemia. 55. A CBC performed on January 29, 2004 showed, again, an elevated white count with a left shift. 56. Dr. Fajardo ordered blood cultures. 57. Approximately two hours after Mr. Aronson presented to the emergency department, Dr. Fajardo ordered that he be discharged to home. 58. On January 30, 2004, Mr. Aronson presented to Dialysis Corp. for another dialysis treatment. 59. On January 30, 2004, Dr. Shaer again changed Mr. Aronson's antibiotics orders, now ordering that he be continued on Vancomycin, but that the Gentamycin be discontinued. 60. Mr. Aronson received no antibiotics during his dialysis session on January 30, 2004. 61. Mr. Aronson was not seen or evaluated or counseled by a physician during the dialysis session on January 29, 2004. 61. On January 31, 2004, Mr. Aronson was admitted to Holy Spirit Hospital with severe arm pain and labored breathing. 62. Mr. Aronson died on February 24, 2004, of complications from sepsis. 63. As a result of the negligence of defendants, plaintiff Stephen J. Aronson suffered the following injuries and losses; (a) wrongful death; (b) ischemic right arm; (c) overwhelming sepsis; (d) endocarditis; (e) extensive hospitalization and multiple surgeiries; (f) physical pain and suffering; (g) mental anguish; (h) embarrassment and disfigurement; (i) loss of past earnings; 8 (j) loss of future earnings; (k) medical care costs; and (1) humiliation. 64. In additional to the injuries and losses sustained by Mr. Aronson, plaintiff Janet Aronson is entitled to compensatory damages as set forth further below. FIRST CAUSE OF ACTION: WRONGFUL :DEATH ACT Janet Aronson, Individually and as Administratrix of the Estate of Stephen J. Aronson v. All Defendants 65. The preceding paragraphs are incorporated by reference as though set forth in their entirety here. 66. Janet Aronson, Administratrix of the Estate of Stephen J. Aronson, brings this action on behalf of the beneficiaries under and by virtue of the Wrongful Death Act, 42 Pa.C.S.A. § 8301, and the applicable Rules of Civil Procedure and decisional law. 67. Janet Aronson, Administratrix of the Estate of Stephen J. Aronson, claims all Administratrix's expenses recoverable under the Wrongful Death Act, including, but not limited to, damages for hospital, medical, funeral and burial expenses and all expenses of administration made necessary because of Stephen J. Aronson's death. 68. The Wrongful Death Act beneficiaries are: a. Janet Aronson (wife). Jonathan Aronson (minor son); and c. Mitchell Aronson (minor son.) 9 69. On behalf of the Wrongful Death beneficiaries, the Administratrix claims damages for monetary support that decedent would have provided to the beneficiaries during his lifetime, including, but not limited to, the support provided or which could have been expected to have been provided to the beneficiaries. 70. On behalf of the Wrongful Death Act beneficiaries, the Administratrix claims damages for loss of companionship, comfort, society, guidance, solace, and protection by the decedent. 71. On behalf of the Wrongful Death beneficiaries, the Administratrix claims damages for the full damages allowed under the Wrongful Death Act of Pennsylvania and decisional law interpreting that Act. WHEREFORE, plaintiff demands damages against defendants, jointly and severally, in an amount in excess of $50,000, and in excess of the prevailing arbitration limits under the Wrongful death Act, exclusive of pre judgment interest, post judgment interest and costs. SECOND CAUSE OF ACTION: SURVIVAL ACTION Janet Aronson, Individually and as Administratrix of the Estate of Stephen J. Aronson v. All Defendants 72. The previous paragraphs are incorporated herein by reference. 73. Janet Aronson, as Administratrix of the Estate of Stephen J. Aronson, brings this Survival Action on behalf of Stephen J. Aronson, under and by virtue of 41 Pa. C.S.A. § 8302 and the applicable Rules of Civil Procedure and decisional law. 74. As a result of the negligent acts and omissions of defendants, Stephen J. Aronson was caused grave injuries and death resulting in the entitlement to damages to the Estate of Stephen J. Aronson, Deceased. 10 75. On behalf of the Survival Act beneficiaries, the Administratrix claims loss of earnings and economic loss of decedent's estate, including, but not limited to, Stephen J. Aronson's total estimated future earnings less the cost of his personal maintenance. 76. On behalf of the Survival Act beneficiaries, the Administratrix claims all loss of income, retirement, and Social Security income as a result of Stephen J. Aronson's death. 77. On behalf of the Survival Act beneficiaries, the Administratrix claims damages for the pain, suffering, and inconvenience endured by Stephen J. Aronson to his death, including, but not limited to his physical pain and suffering, mental pain and suffering. 78. Plaintiff claims the full measure of damages under the Survival Act and decisional law interpreting the Act. WHEREFORE, plaintiff demands damages against defendants, jointly and severally, in an amount in excess of the prevailing arbitration limits under the Survival Act, exclusive of pre- judgment interest, post-judgment interest and costs. COUNT ONE: NEGLIGENCE Plaintiff v. Barbara A. Little, N.P. 79. The preceding paragraphs are incorporated here by reference. 80. The negligence of Nurse Little included the following: (a) failure to appreciate the significance of Mr. Aronson's infection; (b). failure to appreciate the significance of Mr. Aronson's signs and symptoms of infection, including elevated white count and lethergy; (c) failure to timely order antibiotic therapy; (d) failure to transfer Mr. Aronson to the hospital on January 27, 2004; 11 (e) failure to arrange for a physician to see Mr. Aronson in person and evaluate him while he was in the dialysis center on January 27, 2004; (f) failure to appreciate the signs and symptoms of a shunt infection; (g) failure to work up Mr. Aronson for the cause of his infection; (h) failure to appreciate the significance of Mr. Aronson's right arm pain; (i) failure to order appropriate diagnostic studies to work up Mr. Aronson's right arm pain, such as ultrasound or CAT scan; (n) failure to take all reasonable and necessary steps to treat Mr. Aronson's systemic infection. 81. The negligence of Nurse Little was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. COUNT TWO: NEGLIGENCE Plaintiff v. Thomas W. Aldous, M.I). 81 The preceding paragraphs are incorporated hereby reference. 83. The negligence of Dr. Aldous included the following: (a) failure to order that Mr. Aronson be admitted to the hospital on January 26, 2004; (b) failure to request an in-person consultation by an appropriate specialist, such as a nephrologist or an infectious disease physician; (c) negligent discharging of Mr. Aronson from the emergency department on January 26,2004; 12 (d) failure to appreciate the significance of Mr. Aronson's signs and symptoms on January 26, 2004, including his elevated white count, his level of consciousness, his right arm pain and other indications of infection; (e) failure to perform a through examination, including an assessment of Mr. Aronson's right arm; (f) failure to communicate appropriately with Dr. Diamond so as to convey the seriousness of Mr. Aronson's condition; (g) failure to appreciate the gravity of Mr. Aronson's medical condition on January 26, 2004; (b) failure to appreciate the critical nature of Mr. Aronson's infection on January 26, 2004; (i) failure to order appropriate antibiotic therapy to be administered in the hospital on January 26, 2004 and thereafter; and 0) failure to take all reasonable and necessary steps to treat Mr. Aronson's infection in a timely fashion. 84. The negligence of Dr. Aldous was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. COUNT THREE: NEGLIGENCE Plaintiff v. Dialysis Corporation of America 85. The preceding paragraphs are incorporated by reference. 86. The negligence of Dialysis Corp. included the following: 13 (a) failure to have a physician see and evaluate Stephen J. Aronson while a patient at the dialysis facility; (b) failure to implement physician orders regarding antibiotics; (c) failure to refer Stephen J. Aronson to the emergency department on January 26, 2004, January 29, 2004 and/or January 30, 2004. (d) failure to have a physician or other qualified health care provider counsel the patient regarding potential complications of dialysis, including shunt infection; (e) failure to have a qualified health care provider assess Mr. Aronson, particularly in light of his already-known infection; (f) failure to properly train dialysis technicians and other personnel in how to identify and report to a serious infection; (g) failure to administer proper antibiotics; (h) failure to order a consultation with an appropriate specialist, such as infectious disease; (i) failure to have and enforce treatment protocols for dialysis patients with known infections; and 0) failure to have and enforce proper treatment protocols for patients receiving antibiotics during dialysis. 87. The negligence of the Dialysis Corp. was a substantival factor in causing Mr. Aronson to suffer the injuries and losses described above. 14 WHEREFORE, plaintiff demands compensatory damages against all defendants, jointly and severally, in an amount in excess of $50,000 and in excess of the prevailing mandatory arbitration limits, exclusive of pre judgment, post-judgment interest and costs. LAYSER & FREIWALD, P.C. By: aLL& ON J. FREIW ESQUIRE Attorney for Plaintiffs DATED: \ 15? 0 S 15 VERIFICATION 1, JANET ARONSON, Individually and as Administratrix of the Estate of Stephen J. Aronson hereby verify that the facts set forth in the foregoing Complaint is true and correct to the best of our knowledge, information and belief. The undersigned understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. JANET ARONSO , Individually and as Administratrix of the Estate of Stephen J. Aronson CERTIFICATE OF SERVICE I, AARON J. FREIWALD, ESQUIRE, hereby certify that service of a true and correct copy of the Complaint was served upon opposing counsel on this date, via United State First Class Mail, Postage Prepaid, as follows: Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote 1200 Camp Hill Bypass Suite 202 Camp Hill, PA 17011-3700 Michael C. Mongiello, Esquire Foulkrod Ellis 2010 Market Street Camp Hill, PA 17011 James Prahler, Esquire Margolis Edelstein Independence Square West 6th & Walnut Streets, 4th Floor Philadelphia, PA 19103 Peter J. Curry, Esquire Thomas, Thomas & Hafer 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 & FREIWALD, P.C. BY: AARON J. FREIWALD, ESQUIRE Attorney for Plaintiffs DATED: 16 , ,-.? r C7 T .._ h?n l t ( Y ?? ?;I ?l ,? '...I DICKIE, MCCAMEY & CHILCOTE, P.C. BY: FRANCIS E. MARSHALL, JR., ESQUIRE ATTORNEY ID. NO. 27594 BY: THOMAS M. CHAIRS, ESQUIRE ATTORNEY ID. NO. 78565 1200 Camp Hill Bypass, Suite 205 Camp Hill, PA 17011 (717) 7314800 (Tel) (717) 731-4803 (Fax) JANET ARONSON, Administratrix of the Estate of STEPHEN J. ARONSON, Deceased, Plaintiff ATTORNEY FOR DEFENDANT THOMAS W. ALDOUS, M.D. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA : NO. 05-6393 : CIVII. ACTION - MEDICAL PROFESSIONAL BARBARA A. LITTLE, N.P., THOMAS W. LIABILITY ACTION ALDOUS, M.D. and DIALYSIS CORPORATION OF AMERICA, Defendants JURY TRIAL DEMANDED ENTRY OF APPEARANCE TO THE PROTHONOTARY: Please enter the appearance of Francis E. Marshall, Jr., Esquire, Thomas M. Chairs, Esquire and Marcelle M. Theis, Esquire, on behalf of Defendant, Thomas W. Aldous with respect to the above-captioned matter. Date: January 9, 2006 Respectfully submitted, DICKIE, MCCAMEY & CHILCOTE, P.C. By: arcelle M. Theis, Esquire Supreme Court I.D. #49589 Francis E. Marshall, Jr., Esquire Supreme Court I. D. #27594 Thomas M. Chairs, Esquire Supreme Court I.D. #78565 1200 Camp Hill Bypass, Suite 205 Camp Hill, PA. 17011-3700 (717) 731-4800 Attorney for Defendant Thomas W. Aldous, M.D. CERTIFICATE OF SERVICE AND NOW, this 9th day of January, 2006, I, Thomas M. Chairs, Esquire, hereby certify that I did serve a true and correct copy of the foregoing document upon all counsel of record or parties involved by depositing, or causing to be deposited, same in the U.S. mail, postage prepaid, at Camp Hill, Pennsylvania, addressed as follows: Aaron J. Freiwald, Esquire LAYSER & FREIWALD, P.C. 1500 Walnut Street 18th Floor Philadelphia, PA 19102 (Counsel for Plaintiffi Barbara A. Little, N.P. 1740 Towpath Road Dauphin, PA 17018 Andrew H. Foulkrod, Esquire Michael C. Mongiello, Esquire FOULKROD ELLIS 2010 Market Street Camp Hill, PA 17011 James M. Prahler, Esquire Margolis Edelstein Independent Square West 6th & Walnut Streets, 4th Floor Philadelphia, PA 19103 Peter J. Curry, Esquire THOMAS, THOMAS & HAFER, LLP 305 N. Front Street P.O. Box 999 Harrisburg, PA 17108 'Ice Thomas M. M airs, Esquire r- ? C ?? C.._ '_? (ti i .__ ? _ f?J .. :f I?. :.7 LAYSER & FREIWALD, P.C. By: Aaron J. Freiwald, Esquire aif la serfreiwald.com Attorney I.D. No. 78028 1500 Walnut Street, 18' Floor Philadelphia, PA 19102 (215) 875-8000 JANET ARONSON, Executrix of the Estate of STEPHEN J. ARONSON, deceased Plaintiffs V. BARBARA A. LITTLE, N.P., et al. Attorney for Plaintiffs COURT OF COMMON PLEAS OF CUMBERLAND COUNTY NO. 05-6393 AFFIDAVIT OF SERVICE I, AARON J. FREIWALD, ESQUIRE, attorney for plaintiffs in the above-referenced matter, being duly sworn, deposes and says as follows: On December 15, 2005, plaintiffs filed a Writ of Summons naming Thomas W. Aldous, M.D., as a defendant in this lawsuit. See Writ of Summons as Exhibit "A." 2. On December 30, 2005, defendant Thomas W. Aldous, M.D. was served. See letter attached as Exhibit "B." 3. All of the above is true and correct to the best of my knowledge, information and belief. LAYSER & FREIWALD, P.C. BY: ()?? DATED: \lt AARON J. FREIWALD, ESQUIRE Attorney for Plaintiffs CERTIFICATE OF SERVICE I, AARON J. FREIWALD, ESQUIRE, hereby certify that service of a true and correct of the attached Affidavit of Service was served upon the following counsel on this date, via State First Class Mail, Postage Prepaid, as follows: Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote 1200 Camp Hill Bypass Suite 205 Camp Hill, PA 17011-3700 Michael C. Mongiello, Esquire Foulkrod Ellis 2010 Market Street Camp Hill, PA 17011 James Prahler, Esquire Margolis Edelstein Independence Square West 6th & Walnut Streets, 4th Floor Philadelphia, PA 19103 Peter J. Curry, Esquire Thomas, Thomas & Hafer 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 LAYSE & FREIWALD, P.C. BY: AAR J. FREIWALD, ESQUIRE TELN ? x??lb,t+ Commonwealth of Pennsylvania County of Cumberland WRIT OF SUMMONS JANET ARONSON, ADMINISTRATRIX OF THE ESTATE OF STEPHEN J ARONSON,DECEASED 34 GREENMONT DRIVE ENOLA, PA 17025 Plaintiff Vs. BARBARA A. LITTLE, N.P. 1740 TOWPATH ROAD DAUPHIN, PA 17018 AND THOMAS W. ALDOUS, M.D. 503 N. 21sT STREET CAMP HILL, PA 17011 AND DIALYSIS CORPORATION OF AMERICA 27 MILLER STREET LEMOYNE, PA 17043 Defendant Court of Common Pleas No. 05-6393 CIVIL TERM In CivilAction-Law To BARBARA A. LITTLE, N.P., AND THOMAS W. ALDOUS, M.D. AND DIALYSIS CORPORATION OF AMERICA, You are hereby notified that JANET ARONSON, ADMINISTRATRIX OF THE ESTATE OF STEPHEN J. ARONSON, DECEASED, the Plaintiff has / have commenced an action in Civil Action-Law against you which you are required to defend or a default judgment may be entered against you. (SEAL) Prothonotary Date DECEMBER 15, 2005 By Deputy Attorney: Name: AARON J. FRIEWALD, ESQUIRE Address: LAYSER & FREIWALD, P.C. 1500 WALNUT STREET, 18TH FLOOR PHILADELPHIA, PA 19102 Attorney for: Plaintiff Telephone: 215-875-8000 Supreme Court ID No. 78028 X 7 O Q SHERIFF'S RETURN - REGULAR CASE NO: 2005-06393 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND ARONSON JANET ADMIN EST VS LITTLE BARBARA A NP ET AL DOUGLAS RUZANSKI , Sheriff or Deputy Sheriff of Cumberland County,Pennsylvania, who being duly sworn according to law, says, the within WRIT OF SUMMONS was served upon ALDOUS THOMAS W MD the DEFENDANT , at 1323:00 HOURS, on the 30th day of December , 2005 at 210 SENATE AVENUE 3RD FLOOR CAMP HILL, PA 17011 by handing to TOM MASON, SAFETY & SECURITY MANAGER a true and attested copy of WRIT OF SUMMONS together with and at the same time directing His attention to the contents thereof. Sheriff's Costs: So Answers: Docketing 18.00 {r, ` Service 13.44 Affidavit .00 ?f Surcharge 10.00 R. Thomas Kline .00 41.44 01/03/2006 LAYSER & FREIWA Sworn and Subscribed to before By: me this day of Dep y Sh r ff A.D. Prothonotary . 1 ? J 1 a ?` . tl L.: LAYSER & FREIWALD, P.C. By: Aaron J. Freiwald, Esquire a'f la serfreiwald.com Attorney I.D. No. '8028 1500 Walnut Street, 18°i Floor Philadelphia, PA 19102 (215) 875-8000 Attorney for Plaintiffs JANET ARONSON, Executrix of the Estate of STEPHEN J. ARONSON, deceased Plaintiffs V. BARBARA A. LITTLE, N.P., et al. COURT OF COMMON PLEAS OF CUMBERLAND COUNTY NO. 05-6393 AFFIDAVIT OF SERVICE I, AARON' J. FREIWALD, ESQUIRE, attorney for plaintiffs in the above-referenced matter, being duly sworn, deposes and says as follows: 1. On December 15, 2005, plaintiffs filed a Writ of Summons naming Dialysis Corporation of America, as a defendant in this lawsuit. See Writ of Summons as Exhibit "A." 2. On December 30, 2005, defendant Dialysis Corporation of America was served. See letter attached as Exhibit "B." 3. Ali of the above is true and correct to the best of my knowledge, information and belief. BY: & FREIWALD, P.C. A11JkON J. FREIWALD, ESQUIRE ?\ `?O? Attorney for Plaintiffs DATED: CERTIFICATE OF SERVICE I, AARON J. FREIWALD, ESQUIRE, hereby certify that service of a true and correct of the attached Affidavit of Service was served upon the following counsel on this date, via nited State First Class Mail, Postage Prepaid, as follows: Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote 1200 Camp Hill Bypass Suite 205 Camp Hill, PA 17011-3700 Michael C. Mongiello, Esquire Foulkrod Ellis 2010 Market Street Camp Hill, PA 17011 James Prahler, Esquire Margolis Edelstein Independence Square West 6th & Walnut Streets, 4th Floor Philadelphia, PA 19103 Peter J. Curry, Esquire Thomas, Thomas & Hafer 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 L SER & FREIWALD, P.C. BY: TED: t\1AU AARON J. FREIWALD, ESQUIRE No ?XV` Commonwealth of Pennsylvania County of Cumberland WRIT OF SUMMONS JANET ARONSON, ADMINISTRATRIX OF THE ESTATE OF STEPHEN J ARONSON, DECEASED 34 GREENMONT DRIVE ENOLA, PA 17025 Plaintiff Vs. BARBARA A. LITTLE, N.P. 1740 TOWPATH ROAD DAUPHIN, PA 17018 AND THOMAS W. ALDOUS, M.D. 503 N. 21sT STREET CAMP HILL, PA 17011 AND DIALYSIS CORPORATION OF AMERICA 27 MILLER STREET LEMOYNE, PA 17043 Defendant Court of Common Pleas No. 05-6393 CIVIL TERM In CivilAction-Law To BARBARA A. LITTLE, N.P., AND THOMAS W. ALDOUS, M.D. AND DIALYSIS CORPORATION OF AMERICA, You are hereby notified that JANET ARONSON, ADMINISTRATRIX OF THE ESTATE OF STEPHEN J. ARONSON, DECEASED, the Plaintiff has / have commenced an action in Civil Action-Law against you which you are required to defend or a default judgment may be entered against you. (SEAL) Prot onotary Date DECEMBER 15, 2005 By Deputy Attorney: Name: AARON J. FRIEWALD, ESQUIRE Address: LAYSER & FREIWALD, P.C. 1500 WALNUT STREET, 18Ta FLOOR PHILADELPHIA, PA 19102 Attorney for: Plaintiff Telephone: 215-875-8000 Supreme Court ID No. 78028 ?xG? } ? ? ?- L? SHERIFF'S RETURN - REGULAR CASE NO: 2005-06393 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND ARONSON JANET ADMIN EST OF VS LITTLE BARBARA A NP ET AL DOUGLAS RUZANSKI Sheriff or Deputy Sheriff of Cumberland County,Pennsylvania, who being duly sworn according to law, says, the within WRIT OF SUMMONS was served upon DIALYSIS CORPORATION OF AMERICA the DEFENDANT , at 1341:00 HOURS, on the 30th day of December , 2005 at 27 MILLER STREET LEMOYNE. PA 17 JASON FARROW by handing to NURSE ADMINISTRATOR a true and attested copy of WRIT OF SUMMONS together with and at the same time directing His attention to the contents thereof. Sheriff's Costs: So Answers: Docketing 6.00 Service .00 Affidavit .00 Surcharge 10.00 R. Thomas Kline .00 16.00 01/03/2006 LAYSER & FREIWALD ^ Sworn and Subscribed to before By: me this day of 15eputy heri A.D. Prothonotary ,, ri a c _ __ c ?, ... ? ? v:i FOULKROD ELLIS Professional Corporation 2010 Market Street Camp Hill, PA 17011 Phone: (717) 909-7006 Attorney for Defendant: Fax: (717) 909-6955 Barbara A Little N P JANET ARONSON, as Administratrix of the : IN THE COURT OF COMMON PLEAS Estate of STEPHEN J. ARONSON, : CUMBERLAND COUNTY, PENNSYLVANIA Deceased, Plaintiff NO. 05-6393 V. CIVIL ACTION - LAW BARBARA A. LITTLE, N.P., THOMAS W. ALDOUS, M.D. and DIALYSIS CORPORATION OF AMERICA, Defendants JURY TRIAL DEMANDED PRELIMINARY OBJECTION TO PLAINTIFF'S COMPLAINT OF DEFENDANT, BARBARA A. LITTLE, N.P. AND NOW comes Defendant, Barbara A. Little, N.P. ("Nurse Little"), by and through her counsel, Foulkrod Ellis, and preliminarily objects to Plaintiff s Complaint as follows: This is a medical professional liability action in which Plaintiff alleges that Nurse Little negligently failed to treat sepsis resulting in death. A copy of Plaintiff s Complaint is attached hereto as Exhibit "I". Although Nurse Little is currently a Nurse Practitioner, she was at all times relevant to this lawsuit a Registered Professional Nurse. See Affidavit attached hereto as Exhibit "2". 3. Nurse Little's counsel so advised Plaintiff's counsel by letter of December 27, 2005, following receipt of the Writ of Summons but prior to a Complaint being filed. A copy of said letter is attached hereto as Exhibit "3". 4. Notwithstanding Plaintiff s counsel's awareness of Nurse Little's status as a Registered Professional Nurse at the time she cared for Plaintiff s Decedent, Plaintiff avers in her Complaint that Nurse Little breached duties applicable to a Nurse Practitioner. See Supporting Brief. WHEREFORE, it is respectfully requested that this Honorable Court enter the attached Order. Respectfully submitted, FOULKROD ELLIS PROFESSIONAL CORPORATION I By: A/ t, . Michael C. Mong' llo, Esquire Attorney I.D. No. 87532 Date: January 11 .2006 xh ) LAYSER & FREIWAI-D, P.C. By: Aaron J. FreiwaId, Esquire aifn 1ayserfreiwald.com Attorney I.D. No. 78028 1500 Walnut Street, 18' Floor Philadelphia, PA 19102 (215) 875-8000 JANET ARONSON, Administratrix of the Estate of STEPHEN J. ARONSON, deceased 34 Greenmont Drive Enola, PA 17025, Plaintiffs, V. BARBARA A, LITTLE, N.P. 1740 Towpath Road Dauphin, PA 17018 and THOMAS W. ALDOUS, M.D. 503 N. 21st Street Camp Hill, PA 17011 and Attorney for Plaintiffs COURT OF COMMON PLEAS OF CUMBERLAND COUNTY NO.: 05-6393 JURY TRIAL DEMANDED CIVIL ACTION - COMPLAINT [MEDICAL MALPRACTICE 2M] NOTICE You have been sued in court. If you wish to defend against the claims set forth in the following pages, you must tale action within twenty (20) days after this complaint and notice are served, by entering a written appearance personally or by attorney and filing in writing with the court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the rase may proceed without you and a judgment may be entered against you by the court without further notice for any money claimed in the complaint or for any other claim or relief requated by the plaintiff. You may lose money or property or other rights important to you- You should take this paper to your lawyer at once. If you do not have a lawyer or cannot afford one, go to or telephone the office set forth below to find out where you can get legal help. Cumberland County Bar Association 32 South Bedford Street Cahsle, PA 17013 717-249-3166 AVISO U han demandado a usted en ]a carte. Si usted quiere defendase de estas demandas ezpuestas en )as paginas siguientes, useted tiene veinte (20) dias de plaza at partir de Is fecha de la demanda y Is notification. Hace flata asentar una comparencia escrita o en persona o con on abogado y entregar a ]a carte en forma esctita sus defenses o sus objeciones a [as demandas en contra de so persona. Sea avisado que si usted no se defrende, Is carte tomara medidas y puede continuar Is demands en contra suya sin previo aviso a notificacion. Adeni la puede decidir a favor del demandante y requiers que usted cumpla con codas ias provisiones de esta demands. Uted puede perer dinero o sus propiedades u estrus derechos importantes pare sited. Lieve esta demands a on abogado inmediatamente. Si no tiene abogado o at no tiene el dinem soficiente de pagar tal servicio. Vaya en persona o Hume per telefono a is oficina cuya direction se encuentra escrita abajo pare averiguar donde se puede couseguir asistencia legal. Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 717-249-3166 DIALYSIS CORPORATION OF AMERICA: 27 Miller Street Lemoyne, PA 17043 Defendants COMPLAINT Plaintiff Janet Aronson is the Administratrix of the Estate of Stephen J. Aronson, deceased. 2. Mrs. Aronson is an adult citizen of the Commonwealth of Pennsylvania, residing at 34 Greenmont Drive, Enola, Pennsylvania 17025. 3. Plaintiffs decedent, Stephen J. Aronson, was born on April 11, 1949 and died on February 24, 2004 at age 54. 4. Defendant Barbara A. Little, N.P. ("Nurse Little") is a nurse. practitioner, licensed in the Commonwealth of Pennsylvania, who maintained professional offices at 4700 Union Deposit Road, Suite 240, Harrisburg, Pennsylvania 17111. Plaintiff is asserting aprofessional liability action against this defendant. Defendant Thomas W. Aldous, M.D. ("Dr. Aldous") is a physician, licensed in the Commonwealth of Pennsylvania, who maintained professional offices at Holy Spirit Hospital, at 503 N. 21'` Street, Camp Hill, Pennsylvania 17011. Plaintiff is asserting a professional liability action against this defendant. Defendant Dialysis Corporation of America ("Dialysis Corp.") is a corporation or other legal entity, organized and operating under the laws of the Commonwealth of Pennsylvania, that, at all relevant times, owned and operated a facility located at 27 Miller Street, Lemoyne, Pennsylvania 17043. Plaintiff is asserting a professional liabili action against this defendant. At all relevant times, Nurse Little was an agent or employee of Hershey Kidney Specialists. At all relevant times, Dr. Aldous was an agent, servant, employee and/or ostensible agents of Holy Spirit Hospital. 9. At all relevant times, defendant Dialysis Corp. acted through the conduct of its employees, including but not limited to physicians, dialysis technicians, nurses and other staff in rendering medical care and treatment to patients such as Stephen Aronson. 10. At all relevant times, all defendants owed a duty of care to Stephen J. Aronson. 11. Each defendant deviated from accepted standards of care, as set forth more particularly below. 12. As a direct result of the negligence of defendants, individually and jointly together, Stephen J. Aronson was caused to suffer serious personal and other injuries, including, ultimately, his death. 13. Plaintiff Stephen J. Aronson had a history of diabetes and kidney failure. 14. In 2003, Mr. Aronson had placed a dialysis shunt in his left arm in anticipation of dialysis. 15. Mr. Aronson underwent his first dialysis treatment on January 24, 2004 at Dialysis Corp., in Lemoyne, Pennsylvania. 16. Mr. Aronson was not seen or evaluated or counseled by a. physician during his time at dialysis on January 24, 2004. 17. On January 26, 2004 at approximately 5:15 p.m., Mr. Aronson presented to the emergency department of Holy Spirit Hospital complaining of shortness of breath lasting several hours. 18. Mr. Aronson also complained on arrival to the emergency department of a diminished level of consciousness and decreased memory for the previous 24 hours, as well as right arm soreness. 19. On triage, it was noted that Mr. Aronson had an elevated temperature to 100.4, blood pressure pf 141/55, pulse of 92, respirations of 18, and a pulse ox of only 87 percent on room air. 20. The triage nurse also noted that Mr. Aronson was complaining of difficulty swallowing and of bleeding from the dialysis shunt in his right arm. 21. Dr. Philip Maguire, the attending emergency department physician, evaluated Mr. Aronson at approximately 6:25 p.m. on January 26, 2004 and ordered, among other things, Lasix for Mr. Aronson's shortness of breath. 22. Dr. Maguire ordered an EKG, chest x-ray, IV fluids, blood work and blood cultures. 23. Mr. Aronson's chest x-ray showed evidence of congestive heart failure. 24. Mr. Aronson's EKG showed a normal sinus rhythm. 25. The results of Mr. Aronson's complete blood count (CBQ showed an elevated white count with a marked left shift. 26. Mr. Aronson's nephrologist, Dr. Jonathan Diamond was consulted at approximately 8:35 p.m. by telephone, but apparently Dr. Diamond did not come to see his patient in the hospital. 27. No antibiotics were given in the emergency department. 28. Defendant Dr. Aldous also was attending physician in the emergency department at Holy Spirit Hospital on January 26, 2004. 29. Dr. Aldous saw Mr. Aronson in the ER on January 26, 2004. 30. Dr. Aldous was aware of Mr. Aronson's medical history, the complaints that led him to seek emergency medical attention and the treatment he has received in the ER. 31. Dr. Aldous consulted with Dr. Diamond, apparently by telephone. 32. Dr. Aldous did not insist on or arrange for a face-to-face consultation by Dr. Diamond or another appropriate specialist. 33. At approximately 11:00 p.m., Dr. Aldous discharged Mr. Aronson from the ER. 34. Dr. Aldous wrote an "addendum" to Mr. Aronson's medical chart, which proparts to summarize Dr. Aldous' involvement in Mr. Aronson's care and which is dated February 11, 2004. 35. Even though Dr. Aldous' note is dated a significant period of time later, he makes no mention of evaluating Mr. Aronson's dialysis shunt site. 36. Mr. Aronson was discharged to home from the emergency department with instructions to follow up with his scheduled dialysis appointment the following day. 37. On January 27, 2004, Mr. Aronson presented for dialysis at the Dialysis Corp. in Lemoyne. 38. During Mr. Aronson's dialysis treatment, a call was received from Dr. Diamond notifying the dialysis center that Mr. Aronson's blood cultures taken the previous evening at Holy Spirit Hospital were positive. 39. Dr. Diamond gave telephone orders for Mr. Aronson to be given Vancomycin and Gentamycin, two antibiotic medications. 40. Dr. Diamond further ordered that Mr. Aronson be given additional Vancomycin at his regularly scheduled dialysis appointment, on January 29, 2004. 41. Nurse Little saw Mr. Aronson at the Dialysis center on January 27, 2004, Nurse Little noted Mr. Aronson to be "very lethargic." 42. Nurse Little communicated with Dr. Diamond by telephone, but did not arrange for Mr. Aronson to be seen by a physician or to be transferred to the hospital. 43. During dialysis on January 27, 2004, blood was drawn for a CBC. 44. Mr. Aronson was not seen or evaluated or counseled by any physician at the dialysis session on January 27, 2004. 45. The results of the CBC from January 27, 2004, were available the following day and revealed a white count of greater than 22,000. 46. The CBC results were sent by telefax on January 28, 2004 to Hershey Kidney Specialists with a request for antibiotic orders. 47. Blood culture results from January 27, 2004 confirmed the culture results from January 26, 2004 at Holy Spirit Hospital, which had showed the presence of bacteria in Mr. Aronson's blood. 48. On January 28, 2004, Dr. Andrea Shaer another nephrologist with Hershey Kidney Specialists, communicated orders to defendant Dialysis Corp. that Mr. Aronson be given Vancomycin every other treatment for three weeks and Gentamycin on January 29, 2004 and January 31, 2004. 49. Mr. Aronson returned for dialysis to the Dialysis Corp. on January 29, 2004. 50. During dialysis on January 29, 2004, Mr. Aronson complained of shortness of breath and had a blood pressure of 94 over 50. 51. Per Dr. Shaer's orders, Mr. Aronson was given Gentamycin, but he was not given Vancomycin at the time of dialysis on January 29, 2004. 52. Mr. Aronson was not seen or evaluated or counseled by a physician at the dialysis session on January 29, 2004. 53. On January 29, 2004, Mr. Aronson returned to the emergency department at Holy Spirit Hospital now complaining of memory loss, intermittent shakes, pale skin and feeling like he has "been out of it." 54. In the ER on January 29, 2004, Mr. Aronson was seen by Dr. Amy Fajardo, an attending emergency department physician, whose impression was that Mr. Aronson had altered mental status and hypoglycemia. 55. A CBC performed on January 29, 2004 showed, again, an elevated white count with a left shift. 56. Dr. Fajardo ordered blood cultures. 57. Approximately two hours after Mr. Aronson presented to the emergency department, Dr. Fajardo ordered that he be discharged to home. 7 58. On January 30, 2004, Mr. Aronson presented to Dialysis Corp. for another dialysis treatment. 59. On January 30, 2004, Dr. Shaer again changed Mr. Aronson's antibiotics orders, now ordering that he be continued on Vancomycin, but that the Gentamycin be discontinued. 60. Mr. Aronson received no antibiotics during his dialysis session on January 30, 2004. 61. Mr. Aronson was not seen or evaluated or counseled by a physician during the dialysis session on January 29, 2004. 61. On January 31, 2004, Mr. Aronson was admitted to Holy Spirit Hospital with severe arm pain and labored breathing. 62. Mr. Aronson died on February 24, 2004, of complications from sepsis. 63. As a result of the negligence of defendants, plaintiff Stephen J. Aronson suffered the following injuries and losses; (a) wrongful death; (b) ischemic right arm; (c) overwhelming sepsis; (d) endocarditis; (e) extensive hospitalization and multiple surgeries; (f) physical pain and suffering; (g) mental anguish; (h) embarrassment and disfigurement; (i) loss of past earnings; 8 0) loss of future earnings; (k) medical care costs; and (1) humiliation. 64. In additional to the injuries and losses sustained by Mr. Aronson, plaintiff Janet Aronson is entitled to compensatory damages as set forth further below. FIRST CAUSE OF ACTION: WRONGFUL DEATH ACT Janet Aronson, Individually and as Administratrix of the Estate of Stephen J. Aronson v. All Defendants 65. The preceding paragraphs are incorporated by reference as though set forth in their entirety here. 66. Janet Aronson, Administratrix of the Estate of Stephen J. Aronson, brings this action on behalf of the beneficiaries under and by virtue of the Wrongful Death Act, 42 Pa.C.S.A. § 8301, and the applicable Rules of Civil Procedure and decisional law. 67. Janet Aronson, Administratrix of the Estate of Stephen J. Aronson, claims all Administratrix's expenses recoverable under the Wrongful Death Act, including, but not limited to, damages for hospital, medical, funeral and burial expenses and all expenses of administration made necessary because of Stephen J. Aronson's death. 68. The Wrongful Death Act beneficiaries are: a. Janet Aronson (wife). b. Jonathan Aronson (minor son); and c. Mitchell Aronson (minor son.) 9 69. On behalf of the Wrongful Death beneficiaries, the Administratrix claims damages for monetary support that decedent would have provided to the beneficiaries during his lifetime, including, but not limited to, the support provided or which could have been expected to have been provided to the beneficiaries. 70. On behalf of the Wrongful Death Act beneficiaries, the Administratrix claims damages for loss of companionship, comfort, society, guidance, solace, and protection by the decedent. 71. On behalf of the Wrongful Death beneficiaries, the Administratrix claims damages for the full damages allowed under the Wrongful Death Act of Pennsylvania and decisional law interpreting that Act. WHEREFORE, plaintiff demands damages against defendants, jointly and severally, in an amount in excess of $50,000, and in excess of the prevailing arbitration limits under the Wrongful death Act, exclusive of pre-judgment interest, post judgment interest and costs. SECOND CAUSE OF ACTION: SURVIVAL ACTION Janet Aronson, Individually and as Administratrix of the Estate of Stephen J. Aronson v. All Defendants 72. The previous paragraphs are incorporated herein by reference. 73. Janet Aronson, as Administratrix of the Estate of Stephen J. Aronson, brings this Survival Action on behalf of Stephen J. Aronson, under and by virtue of 41 Pa. C.S.A. § 8302 and the applicable Rules of Civil Procedure and decisional law. 74. As a result of the negligent acts and omissions of defendants, Stephen J. Aronson was caused grave injuries and death resulting in the entitlement to damages to the Estate of Stephen J. Aronson, Deceased. 10 75. On behalf of the Survival Act beneficiaries, the Administratrix claims loss of earnings and economic loss of decedent's estate, including, but not limited to, Stephen J. Aronson's total estimated future earnings less the cost of his personal maintenance. 76. On behalf of the Survival Act beneficiaries, the Administratrix claims all loss of income, retirement, and Social Security income as a result of Stephen J. Aronson's death. 77. On behalf of the Survival Act beneficiaries, the Administratrix claims damages for the pain, suffering, and inconvenience endured by Stephen J. Aronson to his death, including, but not limited to his physical pain and suffering, mental pain and suffering. 78. Plaintiff claims the full measure of damages under the Survival Act and decisional law interpreting the Act. WHEREFORE, plaintiff demands damages against defendants, jointly and severally, in an amount in excess of the prevailing arbitration limits under the Survival Act, exclusive of pre- judgment interest, post-judgment interest and costs. COUNT ONE: NEGLIGENCE Plaintiff v. Barbara A. Little, N.P. 79. The preceding paragraphs are incorporated here by reference. 80. The negligence of Nurse Little included the following: (a) failure to appreciate the significance of Mr. Aronson's infection; (b), failure to appreciate the significance of Mr. Aronson's signs and symptoms of infection, including elevated white count and lethergy; (c) failure to timely order antibiotic therapy; (d) failure to transfer Mr. Aronson to the hospital on January 27, 2004; 11 (e) failure to arrange for a physician to see Mr. Aronson in person and evaluate him while he was in the dialysis center on January 27, 2004; (f) failure to appreciate the signs and symptoms of a shunt infection; (g) failure to work up Mr. Aronson for the cause of his infection; (h) failure to appreciate the significance of Mr. Aronson's right ann pain; (i) failure to order appropriate diagnostic studies to work up Mr. Aronson's right arm pain, such as ultrasound or CAT scan; (n) failure to take all reasonable and necessary steps to treat Mr. Aronson's systemic infection. 81. The negligence of Nurse Little was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. COUNT TWO: NEGLIGENCE Plaintiff v. Thomas W. Aldous. M.D. 82. The preceding paragraphs are incorporated hereby reference. 83. The negligence of Dr. Aldous included the following: (a) failure to order that Mr. Aronson be admitted to the hospital on January 26, 2004; (b) failure to request an in-person consultation by an appropriate specialist, such as a nephrologist or an infectious disease physician; (c) negligent discharging of Mr. Aronson from the emergency department on January 26,2004; 12 (d) failure to appreciate the significance of Mr. Aronson's signs and symptoms on January 26, 2004, including his elevated white count, his level of consciousness, his right arm pain and other indications of infection; (e) failure to perform a through examination, including an assessment of Mr. Aronson's right arm; (f) failure to communicate appropriately with Dr. Diamond so as to convey the seriousness of Mr. Aronson's condition; (g) failure to appreciate the gravity of Mr. Aronson's medical condition on January 26, 2004; (h) failure to appreciate the critical nature of Mr. Aronson's infection on January 26, 2004; (i) failure to order appropriate antibiotic therapy to be administered in the hospital on January 26, 2004 and thereafter; and 0) failure to take all reasonable and necessary steps to treat W. Aronson's infection in a timely fashion. 84. The negligence of Dr. Aldous was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. COUNT THREE: NEGLIGENCE Plaintiff v. Dialysis Corporation of America 85. The preceding paragraphs are incorporated by reference. 86. The negligence of Dialysis Corp. included the following: 13 (a) failure to have a physician see and evaluate Stephen J. Aronson while a patient at the dialysis facility; (b) failure to implement physician orders regarding antibiotics; (c) failure to refer Stephen J. Aronson to the emergency department on January 26, 2004, January 29, 2004 and/or January 30, 2004. (d) failure to have a physician or other qualified health care provider counsel the patient regarding potential complications of dialysis, including shunt infection; (e) failure to have a qualified health care provider assess Mr. Aronson, particularly in light of his already-known infection; (f) failure to properly train dialysis technicians and other personnel in how to identify and report to a serious infection; (g) failure to administer proper antibiotics; (h) failure to order a consultation with an appropriate specialist, such as infectious disease; (i) failure to have and enforce treatment protocols for dialysis patients with known infections; and (j) failure to have and enforce proper treatment protocols for patients receiving antibiotics during dialysis. 87. The negligence of the Dialysis Corp. was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. 14 WHEREFORE, plaintiff demands compensatory damages against all defendants, jointly and severally, in an amount in excess of $50,000 and in excess of the prevailing mandatory arbitration limits, exclusive of pre judgment, post judgment interest and costs. LAYSER & FREIWALD, P.C. By: ON J. FREIW : , ESQUIRE Attorney for Plaintiffs DATED: \ \5 V 4o 15 VERIFICATION I, JANET ARONSON, Individually and as Administratrix of the Estate of Stephen J. Aronson hereby verify that the facts set forth in the foregoing Complaint is true and correct to the best of our knowledge, information and belief. The undersigned understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating, to unworn falsification to authorities. A C! r JANET ARONSON, Individually and as Administratrix of the Estate of Stephen J. Aronson CERTIFICATE OF SERVICE I, AARON J. FREIWALD, ESQUIRE, hereby certify that service of a true and correct copy of the Complaint was served upon opposing counsel on this date, via United State First Class Mail, Postage Prepaid, as follows: Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote 1200 Camp Hill Bypass Suite 202 Camp Hill, PA 17011-3700 Michael C. Mongiello, Esquire Foulkrod Ellis 2010 Market Street Camp Hill, PA 17011 James Prattler, Esquire Margolis Edelstein Independence Square West 6th & Walnut Streets, 4th Floor Philadelphia, PA 19103 Peter J. Curry, Esquire Thomas, Thomas & Hafer 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 & FREIWALD, P.C. BY: AAR-ON J. FREIWALD, ESQUIRE Attorney for Plaintiffs DATED: 1 ti 16 1_ AFFIDAVIT I, Barbara A. Little, N.P., do hereby swear and affirm under penalties prescribed by law that the following is true and correct to the best of my knowledge, intormrxCion and belief; 1. At the time of uty involvement in Stephen T. Aronson's care in January 2004, I was a Registered professional Norse and not a MirGFt Practitioner. 2. I became a Nurse Practitioner after my involvement in Stephen J. Aronson's care, on MM 12-r 200 ( See Exhibit "1" hereto. Dated: i $ Z UO arbara A. Little, N. . Sworn to and subscribed h before me this 1? day of r to 2006. Esc ?o ary Public Notarial Seal Leann M. Bench, Notary Public City of Harrisburg, Dauphin County My Commission Expires Oct. 24, 2006 EXHIBIT 1 he -d i66 ££:ZT 9002-eT-Ndf a y? - fA +v. c rs `° +'? urz s ts? ?. t}"?"r1, ? .s ONO 0-ft Fs w ?. lqw £e'd i66 ££:ZZ 900Z-81-Ndt X G 6,+ 3 FOULKROD ELLIS ATTORNEYS AND COUNSELORS AT LAW 2010 Market Street CAMP HILL, PENNSYLVANIA 17011 PHONE (717) 909-7006 FAX (717) 909-6955 ANDREW H. FOULKROD December 27, 2005 Aaron J. Freiwald, Esquire Layser & Freiwald, P.C. 1500 Walnut Street -18`x' Floor Philadelphia, PA 19102 Re: Janet Aronson v. Little. et al. No. 05-6393 (Cumberland County CCP) Dear Mr. Freiwald: PHONE EXTENSION: 4 andrew@foulkrod.com Responding to your letter of December 22, at all relevant times Nurse Little was an R.N. per my understanding, not a C.R.N.P. Sincerely yours, Andrew H. Foulkrod AHF/cag I, Cheryl A. Garofalo, an employee of the law firm of Foulkrod Ellis, P.C., hereby certify that a true d correct copy of the foregoing document was served upon all counsel of record this day of January, 2006, by depositing said copy in the United States Mail at Camp Hill, Pennsylvania, postage prepaid, first class delivery, and addressed as follows: Aaron J. Freiwald, Esquire Francis E. Marshall, Jr., Esquire Layser & Freiwald, P.C. Thomas M. Chairs, Esquire 1500 Walnut Street, 18`h Floor Marcelle M. Theis, Esquire Philadelphia, PA 19102 Dickie McCamey & Chilcote, P.C. Attorney for Plaintiff 1200 Camp Hill Bypass - Suite 205 Camp Hill, PA 17011 Attorneys for Defendant, Thomas W. Aldous, M. D. Dialysis Corporation of America 27 Miller Street Lemoyne, PA 17043 FOULKROD ELLIS CORPORATION By: A? C Cheryl A. Gar alo a f__ -i CJ SHERIFF'S RETURN - REGULAR CASE NO: 2005-06393 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND ARONSON JANET ADMIN EST OF VS LITTLE BARBARA A NP ET AL DOUGLAS RUZANSKI Sheriff or Deputy Sheriff of Cumberland County,Pennsylvania, who being duly sworn according to law, says, the within WRIT OF SUMMONS was served upon ALDOUS THOMAS W MD the DEFENDANT at 1323:00 HOURS, on the 30th day of December , 2005 at 210 SENATE AVENUE 3RD FLOOR CAMP HILL, PA 17011 by handing to TOM MASON, SAFETY & SECURITY MANAGER a true and attested copy of WRIT OF SUMMONS together with and at the same time directing His attention to the contents thereof. Sheriff's Costs Docketing 18. 00 Service 13. 44 Affidavit . 00 Surcharge 10. 00 .00 41. 44 So Answers: R. Thomas Kline 01/03/20 LAYSER & Sworn and Subscribed to before By: w me this day of ,2 A.D. r Pr otar CASE NO: 2005-06393 P SHERIFF'S RETURN - REGULAR COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND ARONSON JANET ADMIN VS LITTLE BARBARA A NP ET AL DOUGLAS RUZANSKI , Sheriff or Deputy Sheriff of Cumberland County,Pennsylvania, who being duly sworn according to law, says, the within WRIT OF SUMMONS DIALYSIS CORPORATION OF was served upon the DEFENDANT , at 1341:00 HOURS, on the 30th day of December , 2005 at 27 MILLER STREET LEMOYNE, PA 17 by handing to JASON FARROW, NURSE ADMINISTRATOR a true and attested copy of WRIT OF SUMMONS together with and at the same time directing His attention to the contents thereof. Sheriff's Costs Docketing 6.00 Service .00 Affidavit .00 Surcharge 10.00 .00 16.00 Sworn and Subscribed to before me this day of 1 u.cc. <a?.. of G A . D . ono ry So Answers: R. Thomas Kline 01/03/2006 LAYSER & FREIWALD By: Oeputy heri LAYSER & FREIWALD, P.C. By: Aaron J. Freiwald, Esquire aj ,glayserfreiwald.coln Attorney I.D. No. 78028 1500 Walnut Street, 18i6 Floor Philadelphia, PA 19102 (215) 875-8000 JANET ARONSON, Administratrix of the Estate of STEPHEN J. ARONSON, deceased Plaintiffs, V. BARBARA A. LITTLE, N.P., ET AL. Defendants Attorney for Plaintiffs COURT OF COMMON PLEAS OF CUMBERLAND COUNTY NO.: 05-6393 JURY TRIAL DEMANDED CIVIL ACTION - AMENDED COMPLAINT ]MEDICAL MALPRACTICE 2M] NOTICE You have been sued in court. If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this complaint and notice are served, by entering a written appearance personally or by attorney and filing in writing with the court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by the court without further notice for any money claimed in the complaint or for any other claim or relief requested by the plaintiff. You may lose money or property or other rights important to you. You should take this paper to your lawyer at once. If you do not have a lawyer or cannot afford one, go to or telephone the office set forth below to find out where you can get legal help. Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 717-249-3166 AVISO Le ban demandado a usted en la torte. Si usted quiere defenderse de estas demandas expuestas en las paginas siguientes, useted tiene veinte (20) dias de plaao al partir de Is fecha de Is demanda y la notification. Hace flata asentar una comparencia eserna o en persona o con on abogado y entregar a Is torte en forma escrna sus defenses o sus objeciones a las demandas en contra de so persona. Sea avisado que si usted no se defiende, In torte tomara medidas y puede continuar Is demanda en contra soya sin previo aviso o notification. Ademas, la poodle decidir a favor del demandante y requiere clue usted cumpla con todas has provisioner de esta demanda. Uyted puede peter dinero o sus propiedades a ostros derechos importantes para usted. Lieve esta demanda a on abogado inmediatamente. Si no time abogado o si no time el dinero suficiente de pagar tat servicio. Vaya en persona o (lame por telefono a In oficina cuya direction se encuentra escrita abajo para averiguar donde se puede conseguir asistencia legal. Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 717-249-3166 AMENDED COMPLAINT Plaintiff Janet Aronson is the Administratrix of the Estate of Stephen J. Aronson, deceased. 2. Mrs. Aronson is an adult citizen of the Commonwealth of Pennsylvania, residing at 34 Greenmont Drive, Enola, Pennsylvania 17025. 3. Plaintiff's decedent, Stephen J. Aronson, was born on April 11, 1949 and died on February 24, 2004 at age 54. 4. Defendant Barbara A. Little, N.P. (`Nurse Little") is a nurse practitioner, licensed in the Commonwealth of Pennsylvania, who maintained professional offices at 4700 Union Deposit Road, Suite 240, Harrisburg, Pennsylvania 17111. Plaintiff is asserting a professional liability action against this defendant. 5. Defendant Thomas W. Aldous, M.D. ("Dr. Aldous") is a physician, licensed in the Commonwealth of Pennsylvania, who maintained professional offices at Holy Spirit Hospital, at 503 N. 21' Street, Camp Hill, Pennsylvania 17011. Plaintiff is asserting _aprofessional liability action against this defendant. Defendant Dialysis Corporation of America (`Dialysis Corp.") is a corporation or other legal entity, organized and operating under the laws of the Commonwealth of Pennsylvania, that, at all relevant times, owned and operated a facility located at 27 Miller Street, Lemoyne, Pennsylvania 17043. Plaintiff is assertinga professional liability action against this defendant. At all relevant times, Nurse Little was an agent or employee of Hershey Kidney Specialists. 2 8. At all relevant times, Dr. Aldous was an agent, servant, employee and/or ostensible agents of Holy Spirit Hospital. 9. At all relevant times, defendant Dialysis Corp. acted through the conduct of its employees, including but not limited to physicians, dialysis technicians, nurses and other staff in rendering medical care and treatment to patients such as Stephen Aronson. 10. At all relevant times, all defendants owed a duty of care to Stephen J. Aronson. 11. Each defendant deviated from accepted standards of care, as set forth more particularly below. 12. As a direct result of the negligence of defendants, individually and jointly together, Stephen J. Aronson was caused to suffer serious personal and other injuries, including, ultimately, his death. 13. Plaintiff Stephen J. Aronson had a history of diabetes and kidney failure. 14. In 2003, Mr. Aronson had placed a dialysis shunt in his left arm in anticipation of dialysis. 15. Mr. Aronson underwent his first dialysis treatment on January 24, 2004 at Dialysis Corp., in Lemoyne, Pennsylvania. 16. Mr. Aronson was not seen or evaluated or counseled by a physician during his time at dialysis on January 24, 2004. 17. On January 26, 2004 at approximately 5:15 p.m., Mr. Aronson presented to the emergency department of Holy Spirit Hospital complaining of shortness of breath lasting several hours. 18. Mr. Aronson also complained on arrival to the emergency department of a diminished level of consciousness and decreased memory for the previous 24 hours, as well as right arm soreness. 19. On triage, it was noted that Mr. Aronson had an elevated temperature to 100.4, blood pressure pf 141,155, pulse of 92, respirations of 18, and a pulse ox of only 87 percent on room air. 20. The triage nurse also noted that Mr. Aronson was complaining of difficulty swallowing and of bleeding from the dialysis shunt in his right arm. 21. Dr. Philip Maguire, the attending emergency department physician, evaluated Mr. Aronson at approximately 6:25 p.m. on January 26, 2004 and ordered, among other things, Lasix for Mr. Aronson's shortness of breath. 22 Dr. ".Maguire ordered an EKG, chest x-ray, 1V fluids, blood work and blood cultures. 23. Mr. Aronson's chest x-ray showed evidence of congestive heart failure. 24. Vr. Aronson's EKG showed a normal sinus rhythm. 25. The results of Mr. Aronson's complete blood count (CBC;i showed an elevated white count with a marked left shift. 26. Mr. Aronson's nephrologist, Dr Jonathan Diamond was consulted at approximately 8.35 p.rn by telephone, but apparently Dr. Diamond did not come to see his patient in the hospital. 27. 'v ? antih?.)tics were given in. the emergency department. A 28. Defendant Dr. Aldous also was attending physician in the emergency department at Holy Spirit Hospital on January 26, 2004. 29. Dr. Aldous saw Mr. Aronson in the ER on January 26, 2004. 30. Dr. Aldous was aware of Mr. Aronson's medical history, the complaints that led him to seek emergency medical attention and the treatment he has received in the ER. 31. Dr. Aldous consulted with Dr. Diamond, apparently by telephone. 32. Dr. Aldous did not insist on or arrange for a face-to-face consultation by Dr. Diamond or another appropriate specialist. 33. At approximately 11:00 p.m., Dr. Aldous discharged Mr. Aronson from the ER. 34. Dr. Aldous wrote an "addendum" to Mr. Aronson's medical chart, which proparts to summarize Dr. Aldous' involvement in Mr. Aronson's care and which is dated February 11, 2004. 35. Even though Dr. Aldous' note is dated a significant period of time later, he makes no mention of evaluating Mr. Aronson's dialysis shunt site. 36. Mr. Aronson was discharged to home from the emergency department with instructions to follow up with his scheduled dialysis appointment the following day. 37. On January 27, 2004, Mr. Aronson presented for dialysis at the Dialysis Corp. in Lemoyne. 38. During Mr. Aronson's dialysis treatment, a call was received from Dr. Diamond notifying the dialysis center that Mr. Aronson's blood cultures taken the previous evening at Holy Spirit Hospital were positive. 5 39. Dr. Diamond gave telephone orders for Mr. Aronson to be given Vancomycin and Gentamycin, two antibiotic medications. 40. Dr. Diamond further ordered that Mr. Aronson be given additional Vancomycin at his regularly scheduled dialysis appointment, on January 29, 2004. 41. Nurse Little saw Mr. Aronson at the Dialysis center on January 27, 2004, Nurse Little noted Mr. Aronson to be "very lethargic." 42. Nurse Little communicated with Dr. Diamond by telephone, but did not arrange for Mr. Aronson to be seen by a physician or to be transferred to the hospital. 43. During dialysis on January 27, 2004, blood was drawn for a CBC. 44. Mr. Aronson was not seen or evaluated or counseled by any physician at the dialysis session on January 27, 2004. 45. The results of the CBC from January 27, 2004, were available the following day and revealed a white count of greater than 22,000. 46. The CBC results were sent by telefax on January 28, 2004 to Hershey Kidney Specialists with a request for antibiotic orders. 47. Blood culture results from January 27, 2004 confirmed the culture results from January 26, 2004 at Holy Spirit Hospital, which had showed the presence of bacteria in Mr. Aronson's blood. 48. On January 28, 2004, Dr. Andrea Shaer another nephrologist with Hershey Kidney Specialists, communicated orders to defendant Dialysis Corp. that Mr. Aronson be given Vancomycin every other treatment for three weeks and Gentamycin on January 29, 2004 and January 31, 2004. 49. Mr. Aronson returned for dialysis to the Dialysis Corp. on January 29, 2004. 50. During dialysis on January 29, 2004, Mr. Aronson complained of shortness of breath and had a blood pressure of 94 over 50. 51. Per Dr. Shaer's orders, Mr. Aronson was given Gentamycin, but he was not given Vancomycin at the time of dialysis on January 29, 2004. 52. Mr. Aronson was not seen or evaluated or counseled by a physician at the dialysis session on January 29, 2004. 53. On January 29, 2004, Mr. Aronson returned to the emergency department at Holy Spirit Hospital now complaining of memory loss, intermittent shakes, pale skin and feeling like he has "been out of it." 54. In the ER on January 29, 2004, Mr. Aronson was seen by Dr. Amy Fajardo, an attending emergency department physician, whose impression was that Mr. Aronson had altered mental status and hypoglycemia. 55. A CBC performed on January 29, 2004 showed, again, an elevated white count with a left shift. 56. Dr. Fajardo ordered blood cultures. 57. Approximately two hours after Mr. Aronson presented to the emergency department, Dr. Fajardo ordered that he be discharged to home. 58. On January 30, 2004, Mr. Aronson presented to Dialysis Corp. for another dialysis treatment. 59. On January 30, 2004, Dr. Shaer again changed Mr. Aronson's antibiotics orders, now ordering that he be continued on Vancomycin, but that the Gentamycin be discontinued. 7 60, Mr. Aronson received no antibiotics during his dialysis session on January 30, 2004. 61. Mr. Aronson was not seen or evaluated or counseled by a physician during the dialysis session on January 29, 2004. 61. On January 31, 2004, Mr. Aronson was admitted to Holy Spirit Hospital with severe arm pain an d labored breathing. 62. Mr. Aronson died on February 24, 2004, of complications from sepsis. 63. As a result of the negligence of defendants, plaintiff Stephen J. Aronson suffered the following injur ies and losses; (a) wrongful death; (b) ischemic right arm; (c) I overwhelming sepsis; (d) endocarditis; (e) extensive hospitalization and multiple surgeries; (f) physical pain and suffering; (g) mental anguish; (h) embarrassment and disfigurement; (i) loss of past earnings; 0) loss of future earnings; (k) medical care costs; and (1) humiliation. 8 64. In additional to the injuries and losses sustained by Mr. Aronson, plaintiff Janet Aronson is entitled to compensatory damages as set forth further below. FIRST CAUSE OF ACTION: WRONGFUL DEATH ACT Janet Aronson, Individually and as Administratrix of the Estate of Stephen J. Aronson v. All Defendants 65. The preceding paragraphs are incorporated by reference as though set forth in their entirety here. 66. Janet Aronson, Administratrix of the Estate of Stephen J. Aronson, brings this action on behalf of the beneficiaries under and by virtue of the Wrongful Death Act, 42 Pa.C.S.A. § 8301, and the applicable Rules of Civil Procedure and decisional law. 67. Janet Aronson, Administratrix of the Estate of Stephen J. Aronson, claims all Administratrix's expenses recoverable under the Wrongful Death Act, including, but not limited to, damages for hospital, medical, funeral and burial expenses and all expenses of administration made necessary because of Stephen J. Aronson's death. 68. The Wrongful Death Act beneficiaries are: a. Janet Aronson (wife). Jonathan Aronson (minor son); and c. Mitchell Aronson (minor son.) 69. On behalf of the Wrongful Death beneficiaries, the Administratrix claims damages for monetary support that decedent would have provided to the beneficiaries during his lifetime, including, but not limited to, the support provided or which could have been expected to have been provided to the beneficiaries. 70, On behalf of the Wrongful Death Act beneficiaries, the Administratrix claims damages for loss of companionship, comfort, society, guidance, solace, and protection by the decedent. 71. On behalf of the Wrongful Death beneficiaries, the Administratrix claims damages for the full damages allowed under the Wrongful Death Act of Pennsylvania and decisional law interpreting that Act. WHEREFORE, plaintiff demands damages against defendants, jointly and severally, in an amount in excess of $50,000, and in excess of the prevailing arbitration limits under the Wrongful death Act, exclusive of pre-judgment interest, post-judgment interest and costs. SECOND CAUSE OF ACTION: SURVIVAL ACTION Janet Aronson, Individually and as Administratrix of the Estate of Stephen J. Aronson v. All Defendants 72. The previous paragraphs are incorporated herein by reference. 73. Janet Aronson, as Administratrix of the Estate of Stephen J. Aronson, brings this Survival Action on behalf of Stephen J. Aronson, under and by virtue of 41 Pa. C.S.A. § 8302 and the applicable Rules of Civil Procedure and decisional law. 74. As a result of the negligent acts and omissions of defendants, Stephen J. Aronson was caused grave injuries and death resulting in the entitlement to damages to the Estate of Stephen J. Aronson, Deceased. 75. On behalf of the Survival Act beneficiaries, the Administratrix claims loss of earnings and economic loss of decedent's estate, including, but not limited to, Stephen J. Aronson's total estimated future earnings less the cost of his personal maintenance. 10 76, On behalf of the Survival Act beneficiaries, the Administratrix claims all loss of income, retirement, and Social Security income as a result of Stephen J. Aronson's death. 77. On behalf of the Survival Act beneficiaries, the Administratrix claims damages for the pain, suffering, and inconvenience endured by Stephen J. Aronson to his death, including, but not limited to his physical pain and suffering, mental pain and suffering. 78. Plaintiff claims the full measure of damages under the Survival Act and decisional law interpreting the Act. WHEREFORE, plaintiff demands damages against defendants, jointly and severally, in an amount in excess of the prevailing arbitration limits under the Survival Act, exclusive of pre- judgment interest, post judgment interest and costs. COUNT ONE: NEGLIGENCE Plaintiff v. Barbara A. Little, N.P. 79. The preceding paragraphs are incorporated here by reference. 80. The negligence of Nurse Little included the following: (a) failure to appreciate the significance of Mr. Aronson's infection; (b) failure to appreciate the significance of Mr. Aronson's signs and symptoms of infection, including elevated white count and lethergy; (c) failure to recommend transfer of Mr. Aronson to the hospital on January 27, 2004; (d) failure to arrange for a physician to see Mr. Aronson in person and evaluate him while he was in the dialysis center on January 27, 2004; (e) failure to appreciate the signs and symptoms of a shunt infection; 11 (f) failure to perform a thorough nursing assessment of Mr. Aronson regarding his evident infection; (g) failure to appreciate the significance of Mr. Aronson's right arm pain; and (h) failure to take all reasonable and necessary steps to treat Mr. Aronson's systemic infection. 81. The negligence of Nurse Little was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. COUNT TWO: NEGLIGENCE Plaintiff v. Thomas W. Aldous, M.D. 82. The preceding paragraphs are incorporated hereby reference. 83. The negligence of Dr. Aldous included the following: (a) failure to order that Mr. Aronson be admitted to the hospital on January 26, 2004; (b) failure to request an in-person consultation by an appropriate specialist, such as a nephrologist or an infectious disease physician; (c) negligent discharging of Mr. Aronson from the emergency department on January 26,2004; (d) failure to appreciate the significance of Mr. Aronson's signs and symptoms on January 26, 2004, including his elevated white count, his level of consciousness, his right arm pain and other indications of infection; 12 (e) failure to perform a through examination, including an assessment of Mr. Aronson's right arm; (f) failure to communicate appropriately with Dr. Diamond so as to convey the seriousness of Mr. Aronson's condition; (g) failure to appreciate the gravity of Mr. Aronson's medical condition on January 26, 2004; (h) failure to appreciate the critical nature of Mr. Aronson's infection on January 26, 2004; (i) failure to order appropriate antibiotic therapy to be administered in the hospital on January 26, 2004 and thereafter; and 0) failure to take all reasonable and necessary steps to treat Mr. Aronson's infection in a timely fashion. 84. The negligence of Dr. Aldous was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. COUNT THREE: NEGLIGENCE Plaintiff y. Dialysis Corporation of America 85. The preceding paragraphs are incorporated by reference. 86. The negligence of Dialysis Corp. included the following: (a) failure to have a physician see and evaluate Stephen J. Aronson while a patient at the dialysis facility; (b) failure to implement physician orders regarding antibiotics; 13 (c) failure to refer Stephen J. Aronson to the emergency department on January 26, 2004, January 29, 2004 and/or January 30, 2004. (d) failure to have a physician or other qualified health care provider counsel the patient regarding potential complications of dialysis, including shunt infection; (e) failure to have a qualified health care provider assess Mr. Aronson, particularly in light of his already-known infection;. (f) failure to properly train dialysis technicians and other personnel in how to identify and report to a serious infection; (g) failure to administer proper antibiotics; (h) failure to order a consultation with an appropriate specialist, such as infectious disease; (i) failure to have and enforce treatment protocols for dialysis patients with known infections and (J) failure to have and enforce proper treatment protocols for patients receiving antibiotics during dialysis. 87. The negligence of the Dialysis Corp. was a substantial factor in causing Mr. Aronson to suffer -,he injuries and losses described above. 14 WHEREFORE, plaintiff demands compensatory damages against all defendants, jointly and severally, in an amount in excess of $50,000 and in excess of the prevailing mandatory arbitration limits, exclusive of pre-judgment, post judgment interest and costs. LAYSER & FREIWALD, P.C. By: AARON J. FREIWALD, ESQUIRE Attorney for Plaintiffs DATED: '/VIA% n 15 VERIFICATION I, AARON J. FREIWALD, ESQUIRE, hereby verify that the facts set forth in the foregoing Amended Complaint are true and correct to the best of our knowledge, information and belief. The undersigned understand that false statements herein made are subject to the penalties of I8 Pa. C.S. Section 4904 relating to unworn falsification to authorities. AARON J. FREIWALD, ESQUIRE CERTIFICATE OF SERVICE I, AARON J. FREIWALD, ESQUIRE, hereby certify that service of a true and correct copy of the Amended Complaint was served upon opposing counsel on this date, via United State First Class Mail, Postage Prepaid, as follows: Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote 1200 Camp Hill Bypass Suite 202 Camp Hill, PA 17011-3700 Michael C. Mongiello, Esquire Foulkrod Ellis 2010 Market Street Camp Hill, PA 17011 James Prahler, Esquire Margolis Edelstein Independence Square West 6th & Walnut Streets, 4th Floor Philadelphia, PA 19103 Peter J. Curry, Esquire Thomas, Thomas & Hafer 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 LAYSER & FREIWALD, P.C. BY: 0-9-t AARON J. FREIWALD, ESQUIRE Attorney for Plaintiffs DATED: '7NOO 16 c> 4+ LAYSER & FREP,'VALD, P.C. By: Aaron J. Freiwald, Esquire ai fg l ayserfreiw ald. com Attorney I.D. No. 78028 1500 Walnut Street, 18" Floor Philadelphia, PA 19102 (215) 875-8000 Attorney for Plaintiffs JANET ARONSON, Administratrix of the Estate of STEPHEN J. ARONSON, deceased Plaintiffs, V. BARBARA A. LITTLE, N.P., ET AL. COURT OF COMMON PLEAS OF CUMBERLAND COUNTY NO.: 05-6393 Defendants PRAECIPE TO ATTACH VERIFICATION TO THE PROTHONOTARY: Please attach the original Verification to the Amended Complaint. LAYSER & FREIWALD, P.C. By; C kl? AARON J. FREIWALD, ESQUIRE DATED-.' ? (D?zb CERTIFICATE OF SERVICE 1, AARON J. FREIWALD, ESQUIRE, hereby certify that service of a true and correct copy of Praecipe to Attach Verification to the Amended Complaint was served upon the following on this date, via United State First Class Mail, Postage Prepaid, as follows: Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote 1200 Camp Hill Bypass Suite 202 Camp Hill, PA 17011-3700 Michael C. Mongiello, Esquire Foulkrod Ellis 2010 Market Street Camp Hill, PA 17011 James Prahler, Esquire Margolis Edelstein Independence Square West 6th & Walnut Streets, 4th Floor Philadelphia, PA 19103 Peter J. Curry, Esquire Thomas, Thomas & Hafer 3400 Bath Pike Suite 302 Bethlehem, PA 18017 L R &FREIWALD, P.C. By: AARON J. FREIWALD, ESQUIRE Attorney for Plaintiffs DATED: ???? VERIFICATION I, JANET ARONSON, Individually and as Administratrix of the Estate of Stephen J. Aronson hereby verify that the facts set forth in the foregoing Amended Complaint is true and correct to the best of our knowledge, information and belief. The undersigned understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. JANET ONSON, Individually and as Administratrix of the Estate of Stephen J. Aronson LAYSER & FREIWALD, P.C. By: Aaron J. Freiwald, Esquire ai f(a7layserfreiwald.com Attorney I.D. No. 78028 1500 Walnut Street, 18"' Floor Philadelphia, PA 19102 (215) 875-8000 Attorney for Plaintiffs JANET ARONSON, Executrix of the Estate of STEPHEN J. ARONSON, deceased Plaintiffs V. COURT OF COMMON PLEAS OF CUMBERLAND COUNTY JONATHAN R. DIAMOND, M.D., et al. NO. 06-111 JANET ARONSON, Executrix of the Estate of STEPHEN J. ARONSON, deceased COURT OF COMMON PLEAS OF CUMBERLAND COUNTY Plaintiffs V. BARBARA A. LITTLE, N.P., et al. NO. 05-6393 PLAINTIFFS' MOTION TO CONSOLIDATE CASES The claims in both of the above referenced civil actions arise from the same transaction or occurrence, namely, defendants' collective failure to properly treat Stephen J. Aronson in January 2004, leading to his death one month later at age 54. Plaintiffs filed a medical negligence action against defendants Jonathan R. Diamond, M.D., Andrea J. Shaer, M.D., Hershey Kidney Specialists, Inc., :Holy Spirit Hospital, Holy Spirit Health System, Philip Maguire, M.D., Amy M. Fajardo, M.D., and Dialysis Corporation of America-Lemoyne, Aronson v. Jonathan R. Diamond, M.D., et. al., No. 2005- CV-2701-MM ("Aronson I"), on June 30, 2005 in the Dauphin County Court of Common Pleas. A copy of the Complaint is attached as Exhibit "A." An Amended Complaint was filed in this matter on August 22, 2005 to add Medicore, Inc., the owner of the dialysis center and Herbert I. Soller, M.D., the center's medical director. A copy of the Amended Complaint is attached as Exhibit "B." 4. On November 23, 2005, the Court ordered that Aronson I be transferred to Cumberland County. A copy of the Court's Order is attached as Exhibit "C." 5. Based on documents and records produced in Aronson I, plaintiffs filed a second medical negligence action Writ of Summons against Barbara A. Little, N.P., a nurse practitioner involved in Mr. Aronson's care, Thomas W. Aldous, M.D., another emergency department physician, and Dialysis Corporation of America, Aronson v Barbara A. Little. N.P., et al., No.05-6393 ("Aronson IT"), on December 15, 2005 in the Cumberland County Court of Common Pleas. A copy of plaintiffs' Writ of Summons is attached as Exhibit "D." 6. Plaintiffs filed a Complaint in Aronson II, on January 9, 2006 in the Cumberland County Court of Common Pleas. A copy of the Complaint is attached as Exhibit "E." These two related actions now should be consolidated. The parties in both Aronson I and Aronson II were involved in providing care and treatment to Mr. Aronson during the same time period. 9. The facts giving rise to the two actions are essentially the same, except that plaintiff has added new defendants in the new action. 10. Pursuant to Pennsylvania Rule of Civil Procedure 213(a), actions may be consolidated when such actions "involve a common question of law or fact" or "arise from the same transaction or occurrence" in order to "avoid unnecessary cost or delay." Pa. R.C.P. 213 (a). 2 11. "The decision to consolidate actions rests within the discretion of the trial court. In a proper case the court should consolidate separate actions to avoid multiplicity of trial or hearings and to reduce the expense to the parties." Lohmiller v. Weidenbaueh, 302 Pa. Super. 174, 182, 448 A2d 583, 587 (1982). (citations omitted). 12. Aronson I and Aronson II arise from the same occurrences and involve common questions of fact. 13. The consolidation of Aronson I and Aronson II will undoubtably spare valuable judicial resources, minimize any inconvenience to all parties and avoid unnecessary discovery and delay. 14. Accordingly, pursuant to Pa.R.C.P. 213(a), the two actions should be consolidated. WHEREFORE, Plaintiff respectfully requests this court grant Plaintiffs Motion To Consolidate Cases and enter an Order in the form attached hereto. Respectfully submitted, LAYSER & FREIWALD, P.C. BY: AARON J. FIZE)WALD, ESQUIRE Attorney for Plaintiffs DATED: 2410 o b 3 LAYSER & FREIWALD, P.C. By: Aaron J. Freiwald, Esquire aifrcB layserfreiwald.com Attorney I.D. No. 78028 1500 Walnut Street, 18' Floor Philadelphia, PA 19102 (215) 875-8000 Attorney for Plaintiffs JANET ARONSON, Executrix of the Estate of STEPHEN J. ARONSON deceased Plaintiffs V. COURT OF COMMON PLEAS OF CUMBERLAND COUNTY JONATHAN R. DIAMOND, M.D., et al. NO. 06-111 JANET ARONSON, Executrix of the Estate of STEPHEN J. ARONSON, deceased COURT OF COMMON PLEAS OF CUMBERLAND COUNTY Plaintiffs V. BARBARA A. LITTLE, N.P., et al. NO. 05-6393 PLAINTIFFS' MOTION TO CONSOLIDATE CASES The claims in both of the above referenced civil actions arise from the same transaction or occurrence, namely, defendants' collective failure to properly treat Stephen J. Aronson in January 2004, leading to his death one month later at 54. Plaintiffs filed a medical negligence action against defendants Jonathan R. Diamond, M.D., Andrea J. Shaer, M.D., Hershey Kidney Specialist, Inc., Holy Spirit Hospital, Holy Spirit Health System, Philip Maguire, M.D., Amy M. Fajardo, M.D., and Dialysis Corporation of America- Lemoyne, Aronson v. Jonathan R. Diamond, M.D., et al., No. 2005-CV-2701-MM ("Aronson P'), on June 30, 2005 in the Dauphin County Court of Common Pleas. A copy of the Complaint is attached as Exhibit "A." An Amended Complaint was filed in this matter on August 22, 2005 to add Medicore, Inc., the owner of the dialysis center and Hebert L Soller, M.D., the center's medical director. A copy of the Amended Complaint is attached as Exhibit "B." On November 23, 2005, the Court ordered that Aronson I be transferred to Cumberland County. A copy of the Court's Order is attached as Exhibit "C." Based on documents and records produced in Aronson I, plaintiffs filed a second medical negligence action Writ of Summons against Barbara A. Little, N.P., a nurse practitioner involved in Mr. Aronson's care, Thomas W. Aldous, M.D., another emergency department physician, and Dialysis Corporation of America, Aronson v. Barbara A, Little, N.P., et al., No. 05-6393 ("Aronson IF'), or December 15, 2005 in the Cumberland County Court of Common Pleas. A copy of plaintiffs' Writ of Summons is attached as Exhibit "D." Plaintiffs filed a Complaint in Aronson II on January 9, 2006 in the Cumberland County Court of Commor Pleas. A copy of the Complaint is attached as Exhibit "E." These two related actions now should be consolidated. The parties in both Aronson I and Aronson II were involved in providing care and treatment to Mr. Aronson (luring the same period. The facts ;giving rise to the two actions are essentially the same, except that plaintiff has added new defendants in the new action. Pursuant to Pennsylvania Rule of Civil Procedure 213(a), actions may be consolidated when such actions "involve a common question of law or fact" or "arise from the same transaction or occurrence" in order to "avoid unnecessary cost or delay." Pa.E.C.P. 213(a). 2 "The decision to consolidate actions rests within the discretion of the trial court. In a proper case the court should consolidate separate actions to avoid multiplicity of trial or hearings and to reduce the expense to the parties." Lohmiller v. Weidenbauah. 302 Pa. Super. 174, 182,448 A2d 583,587 (1982). (citations omitted.) Aronson II and Aronson III arise from the same occurrences and involve common questions of fact. The consolidation of Aronson I and Aronson II will undoubtably spare valuable judicial resources, minimize any inconvenience to all parties and avoid unnecessary discovery and delay. Accordingly, pursuant to Pa.R.C.P. 213(a), the two actions should be consolidated. WHEREFORE, Plaintiff respectfully requests this court grant Plaintiffs Motion To Consolidate Cases and enter an Order in the form attached hereto. Respectfully submitted, L S & F IWALD, P.C. BY: AARON J. FREI LD, ESQUIRE Attorney for Plaintiffs DATED: -,711 4{ _ CERTIFICATE OF SERVICE I, AARON J. FREIWALD, ESQUIRE, hereby certify that service of a true and correct copy of Plaintiffs' Motion to Consolidate Cases was served upon opposing counsel on this date, via United States First Class Mail, Postage Prepaid, as follows: Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote 1200 Camp Hill Bypass Suite 202 Camp Hill, PA 17011-3700 Michael C. Mongiello, Esquire Foulkrod Ellis 2010 Market Street Camp Hill, PA 17011 James Prahler, Esquire Margolis Edelstein Independence Square West 6th & Walrmt Streets, 4th Floor Philadelphia, PA 19103 Peter J. Curry, Esquire Thomas, Thomas & Hafer 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 Respectfully Submitted, Dated: `A aG LAYSER & FREIWALD, P.C. By: - AARON J. FREIWALD, ESQUIRE Attorney for Plaintiffs x?? b; ?t LAYSER & FREIWALD, P.C. By: Aaron J. Freiwald, Esquire aifnadavserfreiwaid.com Attorney I.D. No. 78028 1500 Walnut Street, 18th Floor Philadelphia, PA 19102 (215) 875-8000 Attorney for Plaintiffs JANET ARONSON, Administratrix of the Estate of STEPHEN J. ARONSON, deceased 34 Greenmont Drive Enola, PA 17025, Plaintiffs, V. COURT OF COMMON PLEAS OF DAUPHIN COUNTY C- PTi JONATHAN R. DIAMOND, M.D. NO.: 2005 " C V " Z -7 (11 4700 Union Deposit Road, Suite 240 Harrisburg, PA 17111 JURY TRIAL DEMANDED and CIVIL ACTION - COMPLAINT [MEDICAL MALPRACTICE 2M] NOTICE You have been sued in court If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this complaint and notice are served, by entering a written appearance personally or by attorney and filing in writing with the court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by the court without further notice for any money claimed in the complaint or for any other claim or relief requested by the plaintiff. You may lose money or property or other rights important to you. You should take this paper to your lawyer at once. If you do not have a lawyer or cannot afford one, go to or telephone the office set forth below to find out where you can get legal help. Dauphin County Lawyer Referral Service 213 North Front Street Harrisburg, PA 17101 (717) 232-7536 AVISO N L t. w CD A T 90 Q1 w Le han demandado a usted en la carte. Si usted quiere defenderse de estas demands expuestas en In paginw siguientes, useted time veinte (20) dies de plazo al partir de Is fecha de In dernmda y la notification. Haoe flata asentar una compmencia escrita o en persona o con on abogado y entregar a Is torte en forma escrita aus defenses o sus objeciones a In demandas an contra de so persona Sea avisado que si usted no se defiende, Is torte tomara medidas y puede continuar Is demanda en contra soya sin previo aviso o notification. Aderm, la puede decidir a favor del demandante y requiere que usted cumpla con todas In provisions de esta demands Usted puede parer dincro o sus propiedades u ostros derechos importantes para usted. Lieve esta demands a on abogado inmediatamente. Si no time abogado o sf no time el dinero suficiente de pager tal servicio. Vays en persona o llame por telefono a In ofrdna cuya direction se encuentra escrita abajo pan averiguar donde se puede conseguir asistencla legal. Dauphin County Lawyer Referral Service 213 North Front Street Harrisburg PA 17101 (717) 232-7536 _i r7r rJ Fri --ri C7 ANDREA J. SHAER, M.D. 4700 Union Deposit Road, Suite 240 Harrisburg, PA 17111 and HERSHEY KIDNEY SPECIALISTS, INC. 4700 Union Deposit Road, Suite 240 Harrisburg, PA 17111 and HOLY SPIRIT HOSPITAL 503 N. 21" Street Camp Hill, PA 17011 and HOLY SPIRIT HEALTH SYSTEM 503 N. 2151 Street Camp Hill, PA 17011 and PHILIP MAGUIRE, M.D. 503 N. 21" Street Camp Hill, PA 17011 and AMY M. FAJARDO, M.D. 503 N. 21' Street Camp Hill, PA 17011 and DIALYSIS CORPORATION OF AMERICA-LEMOYNE 27 Miller Street Lemoyne, PA 17043 Defendants COMPLAINT r? C_ C - " rn7: T,i - fi r M r. , :. C7 Cn _ co 1. Plaintiff Janet Aronson is the Administratrix of the Estate of Stephen J. Aronson, deceased. 2. Mrs. Aronson is an adult citizen of the Commonwealth of Pennsylvania, residing at 34 Greenmont Drive, Enola, Pennsylvania 17025. 2 3. Plaintiff's decedent, Stephen J. Aronson, was born on April 11, 1949 and died on February 24, 2004 at age 54. 4. Defendant Jonathan R. Diamond, M.D. ("Dr. Diamond") is a physician, licensed in the Commonwealth of Pennsylvania, who maintained professional offices at 4700 Union Deposit Road, Suite 240, Harrisburg, Pennsylvania 17111. Plaintiff is asserting a professional liability action against this defendant. 5. Defendant Andrea J. Shaer, M.D. ("Dr. Shaer") is a physician, licensed in the Commonwealth of Pennsylvania, who maintained professional offices at 4700 Union Deposit Road, Suite 240, Harrisburg, Pennsylvania 17111. Plaintiff is asserting a professional liability action against this defendant. 6. Defendant Hershey Kidney Specialists, Inc. is a professional corporation, organized and operating under the laws of the Commonwealth of Pennsylvania, that, at all relevant times, was located at 4700 Union Deposit Road, Suite 240, Harrisburg, Pennsylvania 17111. Plaintiff is asserting a professional liability action against this defendant. Defendant Holy Spirit Hospital is a corporation or other legal entity, organized and operating under the laws of the Commonwealth of Pennsylvania, that, at all relevant times, owned and operated a hospital located at 503 N. 21" Street, Camp Hill, Pennsylvania 17011. Plaintiff is asserting a professional liability action against this defendant. 8. Defendant Holy Spirit Health System is a corporation or other legal entity, organized and operating under the laws of the Commonwealth of Pennsylvania, that, at all relevant times, owned and operated a hospital located at 503 N. 21" Street, Camp Hill, Pennsylvania 17011. Plaintiff is asserting a professional liability, action against this defendant. 9. Defendant Philip Maguire, M.D. ("Dr. Maguire") is a physician, licensed in the Commonwealth of Pennsylvania, who maintained professional offices at Holy Spirit Hospital, at 503 N. 21" Street, Camp Hill, Pennsylvania 17011. Plaintiff is asserting a professional liability action against this defendant. 10. Defendant Amy M. Fajardo, M.D. ("Dr. Fajardo') is a physician, licensed in the Commonwealth of Pennsylvania, who maintained professional offices at Holy Spirit Hospital, at 503 N. 21" Street, Camp Hill, Pennsylvania 17011. Plaintiff is asserting a professional liability action against this defendant. 11. Defendant Dialysis Corporation of America-Lemoyne ("Dialysis Corp") is a corporation or other legal entity, organized and operating under the laws of the Commonwealth of Pennsylvania, that, at all relevant times, owned and operated a facility located at 27 Miller Street, Lemoyne, Pennsylvania 17043. Plaintiff is asserting a professional liability action against this defendant. 12. At all relevant times, Dr. Diamond and Dr. Shaer were agents, servants, employees and/or ostensible agents of Hershey Kidney Specialists. 13. Defendant Hershey Kidney Specialists is indirectly liable for any negligent acts or omissions of Dr. Diamond and Dr. Shaer. 14. At all relevant times, Dr. Maguire and Dr. Fajardo were agents, servants, employees and/or ostensible agents of defendants Holy Spirit Hospital and/or Holy Spirit Health System. 15. Defendant Holy Spirit Hospital and/or Holy Spirit Health System are indirectly liable for the negligent acts and omissions of Dr. Maguire and Dr. Fajardo. 4 16. At all relevant times, defendant Dialysis Corp. acted through the conduct of its employees, including but not limited to physicians, dialysis technicians, nurses and other staff in rendering medical care and treatment to patients such as Stephen Aronson. 17. At all relevant times, all defendants owed a duty of care to Stephen J. Aronson. 18. Each defendant deviated from accepted standards of care, as set forth more particularly below. 19. As a direct result of the negligence of defendants, individually and jointly together, Stephen J. Aronson was caused to suffer serious personal and other injuries, including, ultimately, his death. 20. Plaintiff Stephen J. Aronson had a history of diabetes and kidney failure. 21. In 2003, Mr. Aronson had placed a dialysis shunt in his left arm in anticipation of dialysis. 22. Mr. Aronson underwent his first dialysis treatment on January 24, 2004 at Dialysis Corp., in Lemoyne, Pennsylvania. 23. Mr. Aronson was not seen or evaluated or counseled by a physician during his time at dialysis on January 24, 2004. 24. On January 26, 2004 at approximately 5:15 p.m., Mr. Aronson presented to the emergency department of Holy Spirit Hospital complaining of shortness of breath lasting several hours. 25. Mr. Aronson also complained on arrival to the emergency department of a diminished level of consciousness and decreased memory for the previous 24 hours, as well as right arm soreness. 26. On triage, it was noted that Mr. Aronson had an elevated temperature to 100.4, blood pressure pf 141/55, pulse of 92, respirations of 18, and a pulse ox of only 87 percent on room air. 27. The triage nurse also noted that Mr. Aronson was complaining of difficulty swallowing and of bleeding from the dialysis shunt in his right arm. 28. Dr. Maguire, the attending emergency department physician, evaluated Mr. Aronson at approximately 6:25 p.m. on January 26, 2004 and ordered, among other things, Lasix for Mr. Aronson's shortness of breath. 29. Dr. Maguire ordered an EKG, chest x-ray, IV fluids, blood work and blood cultures. 30. Mr. Aronson's chest x-ray showed evidence of congestive heart failure. 31. Mr. Aronson's EKG showed a normal sinus rhythm. 32. The results of Mr. Aronson's complete blood count (CBC) showed an elevated white count with a marked left shift. 33. Mr. Aronson's nephrologist, Dr. Diamond was consulted at approximately 8:35 p.m. by telephone, but apparently Dr. Diamond did not come to see his patient in the hospital. 34. No antibiotics were given in the emergency department. 35. At approximately 11:05 p.m., Mr. Aronson was discharged to home from the emergency department with instructions to follow up with his scheduled dialysis appointment the following day. 36. On January 27, 2004, Mr. Aronson presented for dialysis at the Dialysis Corp. in Lemoyne. 6 37. During Mr. Aronson's dialysis treatment, a call was received from Dr. Diamond notifying the dialysis center that Mr. Aronson's blood cultures taken the previous evening at Holy Spirit Hospital were positive. 38. Dr. Diamond gave telephone orders for Mr. Aronson to be given Vancomycin and Gentamycin, two antibiotic medications. 39. Dr. Diamond further ordered that Mr. Aronson be given additional Vancomycin at his regularly scheduled dialysis appointment, on January 29, 2004. 40. During dialysis on January 27, 2004, Mr. Aronson was found to be very lethargic but with less shortness of breath. 41. During dialysis on January 27, 2004, blood was drawn for a CBC. 42. Mr. Aronson was not seen or evaluated or counseled by any physician at the dialysis session on January 27, 2004. 43. The results of the CBC from January 27, 2004, were available the following day and revealed a white count of greater than 22,000. 44. The CBC results were sent by telefax on January 28, 2004 to Hershey Kidney Specialists with a request for antibiotic orders. 45. Blood culture results from January 27, 2004 confirmed the culture results from January 26, 2004 at Holy Spirit Hospital, which had showed the presence of bacteria in Mr. Aronson's blood. 46. On January 28, 2004, Dr. Shaer communicated orders to defendant Dialysis Corp. that Mr. Aronson be given Vancomycin every other treatment for three weeks and Gentamycin on January 29, 2004 and January 31, 2004. 47. Mr. Aronson returned for dialysis to the Dialysis Corp. on January 29, 2004. 48. During dialysis on January 29, 2004, Mr. Aronson complained of shortness of breath and had a blood pressure of 94 over 50. 49. Per Dr. Shaer's orders, Mr. Aronson was given Gentamycin, but he was not given Vancomycin at the time of dialysis on January 29, 2004. 50. Mr. Aronson was not seen or evaluated or counseled by a physician at the dialysis session on January 29, 2004. 51. On January 29, 2004, Mr. Aronson returned to the emergency department at Holy Spirit Hospital now complaining of memory loss, intermittent shakes, pale skin and feeling like he has "been out of it." 52. In the ER on January 29, 2004, Mr. Aronson was seen by Dr. Fajardo, the attending emergency department physician, whose impression was that Mr. Aronson had altered mental status and hypoglycemia. 53. A CBC performed on January 29, 2004 showed, again, an elevated white count with a left shift. 54. Dr. Fajardo ordered blood cultures. 55. Approximately two hours after Mr. Aronson presented to the emergency department, Dr. Fajardo ordered that he be discharged to home. 8 56. On January 30, 2004, Mr. Aronson presented to Dialysis Corp. for an extra dialysis treatment. 57. On January 30, 2004, Dr. Shaer again changed Mr. Aronson's antibiotics orders, now ordering that he be continued on Vancomycin, but that the Gentamycin be discontinued. 58. Mr. Aronson received no antibiotics during his dialysis session on January 30, 1 2004. 59. Mr. Aronson was not seen or evaluated or counseled by a physician during the dialysis session on January 29, 2004. 60. On January 31, 2004, Mr. Aronson was admitted to Holy Spirit Hospital with severe arm pain and labored breathing. 61. Mr. Aronson died on February 24, 2004. 62. As a result of the negligence of defendants, plaintiff Stephen J. Aronson suffered the following injuries and losses; (a) wrongful death; (b) ischemic right arm; (c) overwhelming sepsis; (d) endocarditis; (e) extensive hospitalization and multiple surgeries; (f) physical pain and suffering; (g) mental anguish; (h) embarrassment and disfigurement; (i) loss of past earnings; 9 0) loss of future earnings; (k) medical care costs; and (1) humiliation. 63. In additional to the injuries and losses sustained by Mr. Aronson, plaintiff Janet Aronson is entitled to compensatory damages as set forth further below. FIRST CAUSE OF ACTION: WRONGFUL DEATH ACT Janet Aronson, Individually and as Administratrix of the Estate of Stephen J Aronson v. All Defendants 64. The preceding paragraphs are incorporated by reference as though set forth in their entirety here. 65. Janet Aronson, Administratrix of the Estate of Stephen J. Aronson, brings this action on behalf of the beneficiaries under and by virtue of the Wrongful Death Act, 42 Pa.C.S.A. § 8301, and the applicable Rules of Civil Procedure and decisional law. 66. Janet Aronson, Administratrix of the Estate of Stephen J. Aronson, claims all Administratrix's expenses recoverable under the Wrongful Death Act, including, but not limited to, damages for hospital, medical, funeral and burial expenses and all expenses of administration made necessary because of Stephen J. Aronson's death. 67. The Wrongful Death Act beneficiaries are: a. Janet Aronson (wife). b. Jonathan Aronson (minor son); and c. Mitchell Aronson (minor son.) 10 68. On behalf of the Wrongful Death beneficiaries, the Administratrix claims damages for monetary support that decedent would have provided to the beneficiaries during his lifetime, including, but not limited to, the support provided or which could have been expected to have been provided to the beneficiaries. 69. On behalf of the Wrongful Death Act beneficiaries, the Administratrix claims damages for loss of companionship, comfort, society, guidance, solace, and protection by the decedent. 70. On behalf of the Wrongful Death beneficiaries, the Administratrix claims damages for the full damages allowed under the Wrongful Death Act of Pennsylvania and decisional law interpreting that Act. WHEREFORE, plaintiff demands damages against defendants, jointly and severally, in an amount in excess of $50,000, and in excess of the prevailing arbitration limits under the Wrongful death Act, exclusive of pre-judgment interest, post-judgment interest and costs. SECOND CAUSE OF ACTION: SURVIVAL ACTION Janet Aronson, Individually and as Administratrix of the Estate of Stephen J. Aronson v. All Defendants 71. The previous paragraphs are incorporated herein by reference. 72. Janet Aronson, as Administratrix of the Estate of Stephen J. Aronson, brings this Survival Action on behalf of Stephen J. Aronson, under and by virtue of 41 Pa. C.S.A. § 8302 and the applicable Rules of Civil Procedure and decisional law. 73. As a result of the negligent acts and omissions of defendants, Stephen J. Aronson was caused grave injuries and death resulting in the entitlement to damages to the Estate of Stephen J. Aronson, Deceased. 11 74. On behalf of the Survival Act beneficiaries, the Administratrix claims loss of earnings and economic loss of decedent's estate, including, but not limited to, Stephen J. Aronson's total estimated future earnings less the cost of his personal maintenance. 75. On behalf of the Survival Act beneficiaries, the Administratrix claims all loss of income, retirement, and Social Security income as a result of Stephen J. Aronson's death. 76. On behalf of the Survival Act beneficiaries, the Administratrix claims damages for the pain, suffering, and inconvenience endured by Stephen J. Aronson to his death, including, but not limited to his physical pain and suffering, mental pain and suffering. 77. Plaintiff claims the full measure of damages under the Survival Act and decisional law interpreting the Act. WHEREFORE, plaintiff demands damages against defendants, jointly and severally, in an amount in excess of the prevailing arbitration limits under the Survival Act, exclusive of pre- judgment interest, post-judgment interest and costs. COUNT ONE: NEGLIGENCE Plaintiff v. Jonathan R. Diamond. M.D. 78. The preceding paragraphs are incorporated here by reference. 79. The negligence of Dr. Diamond included the following: (a) failure to order appropriate antibiotics for Mr. Aronson's bloodstream infection; (b) failure to appreciate the significance of Mr. Aronson's infection; 12 (c) failure to appreciate the significance of Mr. Aronson's signs and symptoms of infection, including elevated white count and positive blood cultures; (d) failure to timely order appropriate antibiotic therapy; (e) failure to admit Mr. Aronson to the hospital on January 26, 2004; (f) failure to see Mr. Aronson in person and evaluate him while he was in the emergency department on January 26, 2004; (g) failure to have Mr. Aronson admitted to the hospital in a timely fashion on or after January 26, 2004; (h) failure to appreciate the signs and symptoms of a shunt infection; (i) failure to work up Mr. Aronson for the cause of his infection; 0) failure to coordinate appropriately with other members of Mr. Aronson's medical team with regard to his antibiotic therapy and other treatment for his infection; (k) failure to appreciate the significance of Mr. Aronson's right arm pain; (1) failure to see, evaluate and/or counsel Mr. Aronson during dialysis sessions on January 24, 2004, January 26, 2004, January 29, 2004 and/or January 30, 2004; (m) failure to request an infectious disease consultation; (n) failure to order appropriate diagnostic studies to work up Mr. Aronson's right arm pain, such as ultrasound or CAT scan; (o) failure to recognize Mr. Aronson's signs of neurologic compromise and 13 mental status changes or indication of a severe systemic infection; and (n) failure to take all reasonable and necessary steps to treat Mr. Aronson's systemic infection. 80. The negligence of Dr. Diamond was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. 81. Defendant Hershey Kidney Specialists is responsible indirectly for the negligence of Dr. Diamond. COUNT TWO: NEGLIGENCE Plaintiff v. Andrea J. Shaer, M.D. 82. The preceding paragraphs are incorporated here by reference. 83. The negligence of Dr. Shaer included the following: (a) failure to order appropriate antibiotics for Mr. Aronson's bloodstream infection; (b) failure to appreciate the significance of Mr. Aronson's infection; (c) failure to appreciate the significance of Mr. Aronson's signs and symptoms of infection, including elevated white count and positive blood cultures; (d) failure to timely order appropriate antibiotic therapy; (e) failure to admit Mr. Aronson to the hospital on January 26, 2004; (f) failure to see Mr. Aronson in person while he was in the emergency department on January 29, 2004; 14 (g) failure to have Mr. Aronson admitted to the hospital in a timely fashion on or after January 26, 2004; (h) failure to appreciate the signs and symptoms of a shunt infection; (i) failure to work up Mr. Aronson for the cause of his infection; 0) failure to coordinate appropriately with other members of Mr. Aronson's medical team with regard to his antibiotic therapy and other treatment for his infection; (k) failure to appreciate the significance of Mr. Aronson's right arm pain; (1) failure to see, evaluated and/or counsel Mr. Aronson during dialysis sessions on January 24, 2004, January 26, 2004, January 24, 2004 and/or January 30, 2004; (m) failure to request an infectious disease consulation; (n) failure to order appropriate diagnostic studies to work up Mr. Aronson's right arm pain, such as ultrasound or CAT scan; (o) failure to recognize Mr. Aronson's signs of neurologic compromise and mental status changes or indication of a severe systemic infection; and (n) failure to take all reasonable and necessary steps to treat Mr. Aronson's systemic infection. 84. The negligence of Dr. Shaer was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. 85. Defendant Hershey Kidney Specialists is responsible indirectly for the negligence of Dr. Shaer. 15 COUNT THREE: NEGLIGENCE Plaintiff v. Philip Maguire. M.D. 86. The preceding paragraphs are incorporated hereby reference. 87. The negligence of Dr. Maguire included the following: (a) failure order that Mr. Aronson be admitted to the hospital on January 26, 2004; (b) failure to request an in-person consultation by an appropriate specialist, such as a nephrologist or an infectious disease physician; (c) negligent discharging of Mr. Aronson from the emergency department on January 26,2004; (d) failure to appreciate the significance of Mr. Aronson's signs and symptoms on January 26, 2004, including his elevated white count, his level of consciousness, his right arm pain and other indications of infection; (e) failure to perform a through examination, including an assessment of Mr. Aronson's right arm; (f) failure to communicate appropriately with Dr. Diamond so as to convey the seriousness of Mr. Aronson's condition; (g) failure to appreciate the gravity of Mr. Aronson's medical condition on January 26, 2004; (h) failure to appreciate the critical nature of Mr. Aronson's infection on January 27, 2004; 16 (i) failure to order appropriate antibiotic therapy to be administered in the hospital on January 26, 2004 and thereafter; and (j) failure to take all reasonable and necessary steps to treat Mr. Aronson's infection in a timely fashion. 88. The negligence of Dr. Maguire was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. 89. Defendants Holy Spirit Hospital and Holy Spirit Health System are legally responsible indirectly for the negligence of Dr. Maguire. COUNT FOUR: NEGLIGENCE Plaintiff v. Amy M. Fajardo. M.D. 90. The preceding paragraphs are incorporated by reference here. 91. The negligence of Dr. Fajardo included the following: (a) failure order that Mr. Aronson be admitted to the hospital on January 29, 2004; (b) failure to request an in-person consultation by an appropriate specialist, such as a nephrologist or an infectious disease physician; (c) negligent discharging of Mr. Aronson from the emergency department on January 29, 2004; (d) failure to appreciate the significance of Mr. Aronson's signs and symptoms on January 29, 2004, including his elevated white count, his level of consciousness, his right arm pain and other indications of infection; 17 (e) failure to perform a through examination, including an assessment of Mr. Aronson's right arm; (f) failure to communicate appropriately with Mr. Aronson's kidney physicians so as to convey the seriousness of Mr. Aronson's condition; (g) failure to appreciate the gravity of Mr. Aronson's medical condition on January 29, 2004; failure to appreciate the critical nature of Mr. Aronson's infection on January 29, 2004; (h) failure to order appropriate antibiotic therapy to be administered in the hospital on January 29, 2004 and thereafter; and (i) failure to take all reasonable and necessary steps to treat Mr. Aronson's infection in a timely fashion. 92. The negligence of Dr. Fajardo was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. 93. Defendants Holy Spirit Hospital and Holy Spirit Health System are legally responsible indirectly for the negligence of Dr. Fajardo. COUNT FIVE: CORPORATE NEGLIGENCE Plaintiff v. Holy Spirit Hospital 94. The preceding paragraphs are incorporated by reference. 95, At relevant times, defendant Holy Spirit Hospital had direct, non-delegable duties to its patients, including Stephen J. Aronson. 18 96. At all relevant times, defendant Holy Spirit Hospital had a duty, among other things, to have and enforce appropriate policies and procedures to protect the safety and well being of its patients. 97. Defendant Holy Spirit Hospital during the relevant time period, failed to have and enforce appropriate policies and procedures regarding the following: (a) consultations by medical specialists to patients in the emergency department; (b) treatment of dialysis patients presenting with signs and symptoms of infection to the emergency department; (c) standards for admitting patients from the emergency department to the hospital; and (d) coordinating care to patients in the emergency department among physicians from multiple medical specialists. 98. The corporate negligence of defendant Holy Spirit Hospital was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. 99. Defendant Holy Spirit Health System is legally responsible indirectly for the corporate negligence of Holy Spirit Hospital. WHEREFORE, plaintiff demands compensatory damages against all defendants, jointly and severally, in an amount in excess of $50,000 and in excess of the prevailing mandatory arbitration limits, exclusive of pre judgment, post judgment interest and costs. 19 COUNT SIX: NEGLIGENCE Plaintiff v. Dialysis Corporation of America-Lemoyne 100. The preceding paragraphs are incorporated by reference. 101. The negligence of Dialysis Corp. included the following: (a) failure to have a physician see and evaluate Stephen J. Aronson while a patient at the dialysis facility; (b) failure to implement physician orders regarding antibiotics; (c) failure to refer Stephen J. Aronson to the emergency department on January 26, 2004, January 29, 2004 and/or January 30, 2004. (d) failure to have a physician or other qualified health care provider counsel the patient regarding potential complications of dialysis, including shunt infection; (e) failure to have a qualified health care provider assess Mr. Aronson, particularly in light of his already-known infection; (f) failure to properly train dialysis technicians and other personnel in how to identify and report to a serious infection; (g) failure to administer proper antibiotics; (h) failure to order a consultation with an appropriate specialist, such as infectious disease; (i) failure to have and enforce treatment protocols for dialysis patients with known infections; and 20 6) failure to have and enforce proper treatment protocols for patients receiving antibiotics during dialysis. 102. The negligence of the Dialysis Corp. was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. WHEREFORE, plaintiff demands compensatory damages against all defendants, jointly and severally, in an amount in excess of $50,000 and in excess of the prevailing mandatory arbitration limits, exclusive of pre-judgment, post judgment interest and costs. LAYSER & FREIWALD, P.C. By: (IALJ AARON J. FREIWALD, QUIRE Attorney for Plaintiffs DATED: 6*;S*? 21 V VERIFICATION I, JANET ARONSON, Individually and as Executrix of the Estate of Stephen J. Aronson hereby verify that the facts set forth in the foregoing Complaint are true and correct to the best of our knowledge, information and belief. The undersigned understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unworn falsification to authorities. 204 JANET ARONSON, Individually and as Administratrix of the Estate of Stephen J. Aronson rt 0 a , / ?n }v j 1 i ' 7? LAYSER & FREIWAL% P.C. By: Aaron J. Freiwald, Esquire aif(a)lavserfreiwald.coln Attorney I.D. No. 78028 1500 Walnut Street, 181' Floor Philadelphia, PA 19102 (215) 875-8000 JANET ARONSON, Administratrix of the Estate of STEPHEN J. ARONSON, deceased 34 Greenmont Drive Enola, PA 17025, Plaintiffs, V. Attorney for Plaintiffs COURT OF COMMON PLEAS OF DAUPHIN COUNTY JONATHAN R. DIAMOND, M.D. NO.: 2405-CV-2701-MM 4700 Union Deposit Road, Suite 240 Harrisburg, PA 17111 JURY TRIAL DEMANDED and AMENDED COMPLAINT (MEDICAL MALPRACTICE 2M) NOTICE You have been sued in court If you wish to defead against the claims set forth in the following pages, you must take action within twenty (20) days after this complain[ and notice are served, by entering a written appearance personally or by attorney and filing in writing with the tour your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by the couch without further notice for any money claimed in the complaint or for any other claim or relief requested by the plaintiff. You may lose money or property or other rights important to you. You should take this paper to your lawyer at once, If you do not have a lawyer or cannot afford one, go to or telephone the office set forth below to find out where you can get legal help. Dauphin County Lawyer Referral Service 213 North Front Street Harrisburg, PA 17101 (717) 232.7536 AVISO c- C' C r' ti rn 7?+ r?J f`3 z> Le ban demandado a usted an Is Corte. Si usted quiere defenderse de estas de pandas expuestas an las paginas siguientes, useted tiene venue (20) dins de plazo al partir de )a fecba de Is demands y la notification. Hace flata asentar una comparencia escrita o en persona o con um abogado y entregar a Is Corte en forma escrita sus defenses o sus objeciones a [as demandas en contra de su persona. Sea avisado que si usted no se defrende, Is torte tomara medidas y puede continuar Is demands m contra suya sin previo aviso o notificacion. Ademas, la puede decidfr a favor del dernandame y requiem que usted cumpla con Was las provisiones de esta demands. Usted puede perer dinero o sus propiedades u ostros derechos importantes para usted. Lieve esta dema¢da a un abogado inmediatamente. Si no tiene abogado o sf no tiene el dinero sufictente de pagar tal servicio. Voya an persona o flame par telefono a Ia nation cayn direction se encuentra escrita abajo pare averiguar donde se poetic conseguir asistencia legal. Dauphin County Lawyer Referral Service 213 North Front Street Harrisburg, PA 17101 (717) 232-7536 r, -t7 ? frl 7C7 r; t ANDREA J. SHAER, M.D. 4700 Union Deposit Road, Suite 240 Harrisburg, PA 17111 and HERSHEY KIDNEY SPECIALISTS, INC. 4700 Union Deposit Road, Suite 240 Harrisburg, PA 17111 and HOLY SPIRIT HOSPITAL 503 N. 21s` Street Camp Hill, PA 17011 and HOLY SPIRIT HEALTH SYSTEM 503 N. 21" Street Camp Hill, PA 17011 and PHILIP MAGUIRE, M.D. 503 N. 21" Street Camp Hill, PA 17011 and AMY M. FAJARDO, M.D. 503 N. 2151 Street Camp Hill, PA 17011 and DIALYSIS CORPORATION OF AMERICA-LEMOYNE 27 Miller Street Lemoyne, PA 17043 and MEDICORE, INC. 2647 West 8151 Street Hialeah, FL 33016 and HERBERT I. SOLLER, M.D. 7 Saratoga Place Camp Hill, PA 17011 Defendants AMENDED COMPLAINT 2 Plaintiff Janet Aronson is the Administratrix of the Estate of Stephen J. Aronson, deceased. 2. Mrs. Aronson is an adult citizen of the Commonwealth of Pennsylvania, residing at 34 Greenmont Drive, Enola, Pennsylvania 17025. 3. Plaintiff's decedent, Stephen J. Aronson, was born on April 11, 1949 and died on February 24, 2004 at age 54. 4. Defendant Jonathan R. Diamond, M.D. ("Dr. Diamond") is a physician, licensed in the Commonwealth of Pennsylvania, who maintained professional offices at 4700 Union Deposit Road, Suite 240, Harrisburg, Pennsylvania 17111. Plaintiff is asserting a professional liability action against this defendant. Defendant Andrea J. Shaer, M.D. ("Dr. Shaer") is a physician, licensed in the Commonwealth of Pennsylvania, who maintained professional offices at 4700 Union Deposit Road, Suite 240, Harrisburg, Pennsylvania 17111. Plaintiff is assertinga professional liability action against this defendant. Defendant Hershey Kidney Specialists, Inc. is a professional corporation, organized and operating under the laws of the Commonwealth of Pennsylvania, that, at all relevant times, was located at 4700 Union Deposit Road, Suite 240, Harrisburg, Pennsylvania 17111. Plaintiff is asserting a professional liability action against this defendant. Defendant Holy Spirit Hospital is a corporation or other legal entity, organized and operating under the laws of the Commonwealth of Pennsylvania, that, at all relevant times, owned and operated a hospital located at 503 N. 21" Street, Camp Hill, Pennsylvania 17011. Plaintiff is asserting a professional liability action against this defendant. 8. Defendant Holy Spirit Health System is a corporation or other legal entity, organized and operating under the laws of the Commonwealth of Pennsylvania, that, at all relevant times, owned and operated a hospital located at 503 N. 21s` Street, Camp Hill, Pennsylvania 17011. Plaintiff is asserting a professional liability action against this defendant. 9. Defendant Philip Maguire, M.D. ("Dr. Maguire") is a physician, licensed in the Commonwealth of Pennsylvania, who maintained professional offices at Holy Spirit Hospital, at 503 N. 21" Street, Camp Hill, Pennsylvania 17011. Plaintiff is asserting a professional liability action against this defendant. 10. Defendant Amy M. Fajardo, M.D. ("Dr. Fajardo") is a physician, licensed in the Commonwealth of Pennsylvania, who maintained professional offices at Holy Spirit Hospital, at 503 N. 21" Street, Camp Hill, Pennsylvania 17011. Plaintiff is asserting a professional liability action against this defendant. 11. Defendant Dialysis Corporation of America-Lemoyne ("Dialysis Corp.") is a corporation or other legal entity, organized and operating under the laws of the Commonwealth of Pennsylvania, that, at all relevant times, owned and operated a facility located at 27 Miller Street, Lemoyne, Pennsylvania 17043. Plaintiff is asserting a professional liability action against this defendant. 12, Defendant Medicore, Inc. is a corporation or other legal entity, with corporate headquarters located at 2647 W81st Street, Hialeah, Florida 33016. Plaintiff is asserting a professional liability action against this defendant. 13. Defendant Herbert I. Soller, M.D. ("Dr. Soller") is a physician, licensed to practice medicine in the Commonwealth of Pennsylvania, who maintained professional offices located at xx, Camp Hill, Pennsylvania 17011. Plaintiff is asserting a professional liability action against this defendant. 14. At all relevant times, Dr. Diamond and Dr. Shaer were agents, servants, employees and/or ostensible agents of Hershey Kidney Specialists. 15. Defendant Hershey Kidney Specialists is indirectly liable for any negligent acts or omissions of Dr. Diamond and Dr. Shaer. 16. At all relevant times, Dr. Maguire and Dr. Fajardo were agents, servants, employees and/or ostensible agents of defendants Holy Spirit Hospital and/or Holy Spirit Health System. 17. Defendant Holy Spirit Hospital and/or Holy Spirit Health System are indirectly liable for the negligent acts and omissions of Dr. Maguire and Dr. Fajardo. 18. At all relevant times, defendant Dialysis Corp. acted through the conduct of its employees, including but not limited to physicians, dialysis technicians, nurses and other staff in rendering medical care and treatment to patients such as Stephen Aronson. 19. At all relevant times, defendant Medicore owned, operated, maintained and/or was legally responsible for defendant Dialysis Corp. 20. At all relevant times, defendant Medicore had responsibility for setting appropriate policy and practices for defendant Dialysis Corp. 21. At all relevant times, Dr. Soller was medical director of defendant Dialysis Corp. 5 22. At all relevant times, Dr. Soller was an agent, servant, employee and/or ostensible agent of defendant Dialysis Corp. and/or Medicore. 23. Defendant Dialysis Corp. and/or Medicore are indirectly responsible for the conduct of Dr. Soller in regard to Stephen Aronson. 24. At all relevant times, all defendants owed a duty of care to Stephen J. Aronson. 25. Each defendant deviated from accepted standards of care, as set forth more particularly below. 26. As a direct result of the negligence of defendants, individually and jointly together, Stephen J. Aronson was caused to suffer serious personal and other injuries, including, ultimately, his death. 27. Plaintiff Stephen J. Aronson had a history of diabetes and kidney failure. 28. In 2003, Mr. Aronson had placed a dialysis shunt in his left arm in anticipation of dialysis. 29. Mr. Aronson underwent his first dialysis treatment on January 24, 2004 at Dialysis Corp., in Lemoyne, Pennsylvania. 30. Mr. Aronson was not seen or evaluated or counseled by a physician during his time at dialysis on January 24, 2004. 31. On January 26, 2004 at approximately 5:15 p.m., Mr. Aronson presented to the emergency department of Holy Spirit Hospital complaining of shortness of breath lasting several hours. 32. Mr. Aronson also complained on arrival to the emergency department of a diminished level of consciousness and decreased memory for the previous 24 hours, as well as right arm soreness. 33. On triage, it was noted that Mr. Aronson had an elevated temperature to 100.4, blood pressure pf 141/55, pulse of 92, respirations of 18, and a pulse ox of only 87 percent on room air. 34. The triage nurse also noted that Mr. Aronson was complaining of difficulty swallowing and of bleeding from the dialysis shunt in his right arm. 35. Dr. Maguire, the attending emergency department physician, evaluated Mr. Aronson at approximately 6:25 p.m. on January 26, 2004 and ordered, among other things, Lasix for Mr. Aronson's shortness of breath. 36. Dr. Maguire ordered an EKG, chest x-ray, IV fluids, blood work and blood cultures. 37. Mr. Aronson's chest x-ray showed evidence of congestive heart failure. 38. Mr. Aronson's EKG showed a normal sinus rhythm. 39. The results of Mr. Aronson's complete blood count (CBQ showed an elevated white count with a marked left shift. 40. Mr. Aronson's nephrologist, Dr. Diamond was consulted at approximately 8:35 p.m. by telephone, but apparently Dr. Diamond did not come to see his patient in the hospital. 41. No antibiotics were given in the emergency department. 42 At approximately 11:05 p.m., Mr. Aronson was discharged to home from the emergency department with instructions to follow up with his scheduled dialysis appointment the following day. 43. On January 27, 2004, Mr. Aronson presented for dialysis at the Dialysis Corp. in Lemoyne. 44. Defendant Dr. Soller was the medical director of the defendant dialysis center. 45. During Mr. Aronson's dialysis treatment, a call was received from Dr. Diamond notifying the dialysis center that Mr. Aronson's blood cultures taken the previous evening at Holy Spirit Hospital were positive. 46. Dr. Diamond gave telephone orders for Mr. Aronson to be given Vancomycin and Gentamycin, two antibiotic medications. 47. Dr. Diamond further ordered that Mr. Aronson be given additional Vancomycin at his regularly scheduled dialysis appointment, on January 29, 2004. 48. During dialysis on January 27, 2004, Mr. Aronson was found to be very lethargic but with less shortness of breath. 49. During dialysis on January 27, 2004, blood was drawn for a CBC. 50. Mr. Aronson was not seen or evaluated or counseled by any physician at the dialysis session on January 27, 2004. 51. The results of the CBC from January 27, 2004, were available the following day and revealed a white count of greater than 22,000. 52. The CBC results were sent by telefax on January 28, 2004 to Hershey Kidney Specialists with a request for antibiotic orders. f 53. Blood culture results from January 27, 2004 confirmed the culture results from January 26, 2004 at Holy Spirit Hospital, which had showed the presence of bacteria in Mr. Aronson's blood. 54. On January 28, 2004, Dr. Shaer communicated orders to defendant Dialysis Corp. that Mr. Aronson be given Vancomycin every other treatment for three weeks and Gentamycin on January 29, 2004 and January 31, 2004. 55. Mr. Aronson returned for dialysis to the Dialysis Corp. on January 29, 2004. 56. During dialysis on January 29, 2004, Mr. Aronson complained of shortness of breath and had a blood pressure of 94 over 50. 57. Per Dr. Shaer's orders, Mr. Aronson was given Gentamycin, but he was not given Vancomycin at the time of dialysis on January 29, 2004. 58. Mr. Aronson was not seen or evaluated or counseled by a physician at the dialysis session on January 29, 2004. 59. On January 29, 2004, Mr. Aronson returned to the emergency department at Holy Spirit Hospital now complaining of memory loss, intermittent shakes, pale skin and feeling like he has "been out of it." 60. In the ER on January 29, 2004, Mr. Aronson was seen by Dr. Fajardo, the attending emergency department physician, whose impression was that Mr. Aronson had altered mental status and hypoglycemia. 61. A CBC performed on January 29, 2004 showed, again, an elevated white count with a left shift. 62. Dr. Fajardo ordered blood cultures. 63, Approximately two hours after Mr. Aronson presented to the emergency department, Dr. Fajardo ordered that he be discharged to home. 64. On January 30, 2004, Mr. Aronson presented to Dialysis Corp. for an extra dialysis treatment. 65. On January 30, 2004, Dr. Shaer again changed Mr. Aronson's antibiotics orders, now ordering that he be continued on Vancomycin, but that the Gentamycin be discontinued. 66. Mr. Aronson received no antibiotics during his dialysis session on January 30, 2004. 67. Mr. Aronson was not seen or evaluated or counseled by a physician during the dialysis session on January 29, 2004. 68. On January 31, 2004, Mr. Aronson was admitted to Holy Spirit Hospital with severe arm pain and labored breathing. 69. Mr. Aronson died on February 24, 2004 of complications of overwhelming sepsis. 70. As a result of the negligence of defendants, plaintiff Stephen J. Aronson suffered the following injuries and losses; (a) wrongful death; (b) ischemic right arm; (c) overwhelming sepsis; (d) endocarditis; (e) extensive hospitalization and multiple surgeries; (f) physical pain and suffering; (g) mental anguish; 10 (h) embarrassment and disfigurement; (i) loss of past earnings; 0) loss of future earnings; (k) medical care costs; and (1) humiliation. 71. In additional to the injuries and losses sustained by Mr. Aronson, plaintiff Janet Aronson is entitled to compensatory damages as set forth further below. FIRST CAUSE OF ACTION: WRONGFUL DEATH ACT Janet Aronson, Individually and as Administratrix of the Estate of Stephen J Aronson v. All Defendants 72. The preceding paragraphs are incorporated by reference as though set forth in their entirety here. 73. Janet Aronson, Administratrix of the Estate of Stephen J. Aronson, brings this action on behalf of the beneficiaries under and by virtue of the Wrongful Death Act, 42 Pa.C.S.A. § 8301, and the applicable Rules of Civil Procedure and decisional law. 74. Janet Aronson, Administratrix of the Estate of Stephen J. Aronson, claims all Administratrix's expenses recoverable under the Wrongful Death Act, including, but not limited to, damages for hospital, medical, funeral and burial expenses and all expenses of administration made necessary because of Stephen J. Aronson's death. 75. The Wrongful Death Act beneficiaries are: a. Janet Aronson (wife). b. Jonathan Aronson (minor son); and 11 C. Mitchell Aronson (minor son.) 76. On behalf of the Wrongful Death beneficiaries, the Administratrix claims damages for monetary support that decedent would have provided to the beneficiaries during his lifetime, including, but not limited to, the support provided or which could have been expected to have been provided to the beneficiaries. 77. On behalf of the Wrongful Death Act beneficiaries, the Administratrix claims damages for loss of companionship, comfort, society, guidance, solace, and protection by the decedent. 78. On behalf of the Wrongful Death beneficiaries, the Administratrix claims damages for the full damages allowed under the Wrongful Death Act of Pennsylvania and decisional law interpreting that Act. WHEREFORE, plaintiff demands damages against defendants, jointly and severally, in an amount in excess of $50,000, and in excess of the prevailing arbitration limits under the Wrongful death Act, exclusive of pre judgment interest, post judgment interest and costs. SECOND CAUSE OF ACTION: SURVIVAL ACTION Janet Aronson, Individually and as Administratrix of the Estate of Stephen J. Aronson v. All Defendants 79. The previous paragraphs are incorporated herein by reference. 80. Janet Aronson, as Administratrix of the Estate of Stephen J. Aronson, brings this Survival Action on behalf of Stephen J. Aronson, under and by virtue of 41 Pa. C.S.A. § 8302 and the applicable Rules of Civil Procedure and decisional law. 12 81. As a result of the negligent acts and omissions of defendants, Stephen J. Aronson was caused grave injuries and death resulting in the entitlement to damages to the Estate of Stephen J. Aronson, Deceased. 82. On behalf of the Survival Act beneficiaries, the Administratrix claims loss of earnings and economic loss of decedent's estate, including, but not limited to, Stephen J. Aronson's total estimated future earnings less the cost of his personal maintenance. 83. On behalf of the Survival Act beneficiaries, the Administratrix claims all loss of income, retirement, and Social Security income as a result of Stephen J. Aronson's death. 84. On behalf of the Survival Act beneficiaries, the Administratrix claims damages for the pain, suffering, and inconvenience endured by Stephen J. Aronson to his death, including, but not limited to his physical pain and suffering, mental pain and suffering. 85. Plaintiff claims the full measure of damages under the Survival Act and decisional law interpreting the Act. WHEREFORE, plaintiff demands damages against defendants, jointly and severally, in an amount in excess of the prevailing arbitration limits under the Survival Act, exclusive of pre- judgment interest, post judgment interest and costs. COUNT ONE: NEGLIGENCE Plaintiff v. Jonathan R. Diamond. M.D. 86, The preceding paragraphs are incorporated here by reference. 87. The negligence of Dr. Diamond included the following: (a) failure to order appropriate antibiotics for Mr. Aronson's bloodstream infection; 13 (b) failure to appreciate the significance of Mr. Aronson's infection; (c) failure to appreciate the significance of Mr. Aronson's signs and symptoms of infection, including elevated white count and positive blood cultures; (d) failure to timely order appropriate antibiotic therapy; (e) failure to admit Mr. Aronson to the hospital on January 26, 2004; (f) failure to see Mr. Aronson in person and evaluate him while he was in the emergency department on January 26, 2004; (g) failure to have Mr. Aronson admitted to the hospital in a timely fashion on or after January 26, 2004; (h) failure to appreciate the signs and symptoms of a shunt infection; (i) failure to work up Mr. Aronson for the cause of his infection; 6) failure to coordinate appropriately with other members of Mr. Aronson's medical team with regard to his antibiotic therapy and other treatment for his infection; (k) failure to appreciate the significance of Mr. Aronson's right arm pain; (1) failure to see, evaluate and/or counsel Mr. Aronson during dialysis sessions on January 24, 2004, January 26, 2004, January 29, 2004 and/or January 30, 2004; (m) failure to request an infectious disease consultation; (n) failure to order appropriate diagnostic studies to work up Mr. Aronson's right arm pain, such as ultrasound or CAT scan; 14 (o) failure to recognize Mr. Aronson's signs of neurologic compromise and mental status changes or indication of a severe systemic infection; and (p) failure to take all reasonable and necessary steps to treat Mr. Aronson's systemic infection. 88. The negligence of Dr. Diamond was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. 89. Defendant Hershey Kidney Specialists is responsible indirectly for the negligence of Dr. Diamond. COUNT TWO: NEGLIGENCE Plaintiff v. Andrea J. Shaer. M.D. 90. The preceding paragraphs are incorporated here by reference. 91. The negligence of Dr. Shaer included the following: (a) failure to order appropriate antibiotics for Mr. Aronson's bloodstream infection; (b) failure to appreciate the significance of Mr. Aronson's infection; (c) failure to appreciate the significance of Mr. Aronson's signs and symptoms of infection, including elevated white count and positive blood cultures; (d) failure to timely order appropriate antibiotic therapy; (e) failure to admit Mr. Aronson to the hospital on January 26, 2004; (f) failure to see Mr. Aronson in person while he was in the emergency department on January 29, 2004; 15 (g) failure to have Mr. Aronson admitted to the hospital in a timely fashion on or after January 26, 2004; (h) failure to appreciate the signs and symptoms of a shunt infection; (i) failure to work up Mr. Aronson for the cause of his infection; 6) failure to coordinate appropriately with other members of Mr. Aronson's medical team with regard to his antibiotic therapy and other treatment for his infection; (k) failure to appreciate the significance of Mr. Aronson's right arm pain; (1) failure to see, evaluated and/or counsel Mr. Aronson during dialysis sessions on January 24, 2004, January 26, 2004, January 29, 2004 and/or January 30, 2004; (m) failure to request an infectious disease consulation; (n) failure to order appropriate diagnostic studies to work up Mr. Aronson's right arm pain, such as ultrasound or CAT scan; (o) failure to recognize Mr. Aronson's signs of neurologic compromise and mental status changes or indication of a severe systemic infection; and (p) failure to take all reasonable and necessary steps to treat Mr. Aronson's systemic infection. 92. The negligence of Dr. Shaer was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. 93. Defendant Hershey Kidney Specialists is responsible indirectly for the negligence of Dr. Shaer. 16 COUNT THREE: NEGLIGENCE Plaintiff v. Philip Maguire, M.D. 94. The preceding paragraphs are incorporated hereby reference. 95. The negligence of Dr. Maguire included the following: (a) failure order that Mr. Aronson be admitted to the hospital on January 26, 2004; (b) failure to request an in-person consultation by an appropriate specialist, such as a nephrologist or an infectious disease physician; (c) negligent discharging of Mr. Aronson from the emergency department on January 26,2004; (d) failure to appreciate the significance of Mr. Aronson's signs and symptoms on January 26, 2004, including his elevated white count, his level of consciousness, his right arm pain and other indications of infection; (e) failure to perform a through examination, including an assessment of Mr. Aronson's right arm; (f) failure to communicate appropriately with Dr. Diamond so as to convey the seriousness of Mr. Aronson's condition; (g) failure to appreciate the gravity of Mr. Aronson's medical condition on January 26, 2004; (h) failure to appreciate the critical nature of Mr. Aronson's infection on January 27, 2004; 17 (i) failure to order appropriate antibiotic therapy to be administered in the hospital on January 26, 2004 and thereafter; and 6) failure to take all reasonable and necessary steps to treat Mr. Aronson's infection in a timely fashion. 96. The negligence of Dr. Maguire was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. 97. Defendants Holy Spirit Hospital and Holy Spirit Health System are legally responsible indirectly for the negligence of Dr. Maguire. COUNT FOUR: NEGLIGENCE Plaintiff v. Amy M. Fajardo, M.D. 98. The preceding paragraphs are incorporated by reference here. 99. The negligence of Dr. Fajardo included the following: (a) failure order that Mr. Aronson be admitted to the hospital on January 29, 2004; (b) failure to request an in-person consultation by an appropriate specialist, such as a nephrologist or an infectious disease physician; (c) negligent discharging of Mr. Aronson from the emergency department on January 29, 2004; (d) failure to appreciate the significance of Mr. Aronson's signs and symptoms on January 29, 2004, including his elevated white count, his level of consciousness, his right arm pain and other indications of infection; 18 (e) failure to perform a through examination, including an assessment of Mr. Aronson's right arm; (f) failure to communicate appropriately with Mr. Aronson's kidney physicians so as to convey the seriousness of Mr. Aronson's condition; (g) failure to appreciate the gravity of Mr. Aronson's medical condition on January 29, 2004; failure to appreciate the critical nature of Mr. Aronson's infection on January 29, 2004; (h) failure to order appropriate antibiotic therapy to be administered in the hospital on January 29, 2004 and thereafter; and (i) failure to take all reasonable and necessary steps to treat Mr. Aronson's infection in a timely fashion. 100. The negligence of Dr. Fajardo was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. 101. Defendants Holy Spirit Hospital and Holy Spirit Health System are legally responsible indirectly for the negligence of Dr. Fajardo. COUNT FIVE: CORPORATE NEGLIGENCE Plaintiff v. How Spirit Hospital 102. The preceding paragraphs are incorporated by reference. 103. At relevant times, defendant Holy Spirit Hospital had direct, non-delegable duties to its patients, including Stephen J. Aronson. 19 104. At all relevant times, defendant Holy Spirit Hospital had a duty, among other things, to have and enforce appropriate policies and procedures to protect the safety and well being of its patients. 105. Defendant Holy Spirit Hospital during the relevant time period, failed to have and enforce appropriate policies and procedures regarding the following: (a) consultations by medical specialists to patients in the emergency department; (b) treatment of dialysis patients presenting with signs and symptoms of infection to the emergency department; (c) standards for admitting patients from the emergency department to the hospital; and (d) coordinating care to patients in the emergency department among physicians from multiple medical specialists. 106. The corporate negligence of defendant Holy Spirit Hospital was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. 107. Defendant Holy Spirit Health System is legally responsible indirectly for the corporate negligence of Holy Spirit Hospital. WHEREFORE, plaintiff demands compensatory damages against all defendants, jointly and severally, in an amount in excess of $50,000 and in excess of the prevailing mandatory arbitration limits, exclusive of pre judgment, post judgment interest and costs. 20 COUNT SIX: NEGLIGENCE Plaintiff v. Dialysis Corporation of America-Lemoyne 108. The preceding paragraphs are incorporated by reference. 109. The negligence of Dialysis Corp. included the following: (a) failure to have a physician see and evaluate Stephen J. Aronson while a patient at the dialysis facility; (b) failure to implement physician orders regarding antibiotics; (c) failure to refer Stephen J. Aronson to the emergency department on January 26, 2004, January 29, 2004 and/or January 30, 2004. (d) failure to have a physician or other qualified health care provider counsel the patient regarding potential complications of dialysis, including shunt infection; (e) failure to have a qualified health care provider assess Mr. Aronson, particularly in light of his already-known infection; (f) failure to properly train dialysis technicians and other personnel in how to identify and report to a serious infection; (g) failure to administer proper antibiotics; (h) failure to order a consultation with an appropriate specialist, such as infectious disease; (i) failure to have and enforce treatment protocols for dialysis patients with known infections; and 21 0) failure to have and enforce proper treatment protocols for patients receiving antibiotics during dialysis. 110. The negligence of the Dialysis Corp, was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. 111. Defendant Medicore is indirectly liable to the negligence of defendant Dialysis Corp. WHEREFORE, plaintiff demands compensatory damages against all defendants, jointly and severally, in an amount in excess of $50,000 and in excess of the prevailing mandatory arbitration limits, exclusive of pre judgment, post judgment interest and costs. COUNT SEVEN: NEGLIGENCE Plaintiff v. Medicore. Inc. 112. The preceding paragraphs are incorporated by reference. 113. The negligence of Medicore included the following: (a) failure to have a physician see and evaluate Stephen J. Aronson while a patient at the dialysis facility; (b) failure to implement physician orders regarding antibiotics; (c) failure to refer Stephen J. Aronson to the emergency department on January 26, 2004, January 29, 2004 and/or January 30, 2004. (d) failure to have a physician or other qualified health care provider counsel the patient regarding potential complications of dialysis, including shunt infection; 22 (e) failure to have a qualified health care provider assess Mr. Aronson, particularly in light of his already-known infection; (f) failure to properly train dialysis technicians and other personnel in how to identify and report to a serious infection; (g) failure to administer proper antibiotics; (h) failure to order a consultation with an appropriate specialist, such as infectious disease; (i) failure to have and enforce treatment protocols for dialysis patients with known infections; and Q) failure to have and enforce proper treatment protocols for patients receiving antibiotics during dialysis. 114. The negligence of Medicore was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. WHEREFORE, plaintiff demands compensatory damages against all defendants, jointly and severally, in an amount in excess of $50,000 and in excess of the prevailing mandatory arbitration limits, exclusive of pre judgment, post judgment interest and costs. COUNT ONE: NEGLIGENCE Plaintiff v. Jonathan R. Diamond, M.D. 115. The preceding paragraphs are incorporated here by reference. 116. The negligence of Dr. Soller included the following: (a) failure to order appropriate antibiotics for Mr. Aronson's bloodstream infection; 23 (b) failure to appreciate the significance of Mr. Aronson's infection; (c) failure to appreciate the significance of Mr. Aronson's signs and symptoms of infection, including elevated white count and positive blood cultures; (d) failure to timely order appropriate antibiotic therapy; (e) failure to admit Mr. Aronson to the hospital on January 26, 2004; (f) failure to see and evaluate Mr. Aronson; (g) failure to have Mr. Aronson admitted to the hospital in a timely fashion on or after January 26, 2004; (h) failure to appreciate the signs and symptoms of a shunt infection; (i) failure to work up Mr. Aronson for the cause of his infection; 0) failure to coordinate appropriately with other members of Mr. Aronson's medical team with regard to his antibiotic therapy and other treatment for his infection; (k) failure to appreciate the significance of Mr. Aronson's right arm pain; (1) failure to see, evaluate and/or counsel Mr. Aronson during dialysis sessions on January 24, 2004, January 26, 2004, January 29, 2004 and/or January 30, 2004; (m) failure to request an infectious disease consultation; (n) failure to order appropriate diagnostic studies to work up Mr. Aronson's right arm pain, such as ultrasound or CAT scan; 24 (o) failure to recognize Mr. Aronson's signs of neurologic compromise and mental status changes or indication of a severe systemic infection; (p) failure to take all reasonable and necessary steps to treat Mr. Aronson's systemic infection; (c) failure to enforce policies and procedures relating to patients who become seriously ill in the dialysis center. 117. The negligence of Dr. Soller was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. 118. Defendant Dialysis Corp. and/or defendant Medicore are responsible indirectly for the negligence of Dr. Diamond. 25 WHEREFORE, plaintiff demands compensatory damages against all defendants, jointly and severally, in an amount in excess of $50,000 and in excess of the prevailing mandatory arbitration limits, exclusive of pre-judgment, post judgment interest and costs. LAYSER & FREIWALD, P.C. c By: AARON J. FREIWALD, ESQUIRE Attorney for Plaintiffs DATEDA46T 26 VERIFICATION I, AARON J. FREIWALD, ESQUIRE, hereby verify that the facts set forth in the foregoing Amended Complaint are true and correct to the best of our knowledge, information and belief. The undersigned understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unworn falsification to authorities. aa??(o AARON J. FREIWALD, SQUIRE 27 CERTIFICATE OF SERVICE I, AARON J. FREIWALD, ESQUIRE, hereby certify that service of a true and correct copy of the attached Amended Complaint was served on opposing counsel on this date, via United States First Class Mail, Postage Prepaid, as follows: Wilbur McCoy Otto, Esquire Dickie, McCamey & Chilcote Two PPG Place, Suite 400 Pittsburgh, PA 15222-5402 Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote 1200 Camp Hill Bypass Suite 202 Camp Hill, PA 17011-3700 Michael C. Mongiello, Esquire Foulkrod Ellis 2010 Market Street Camp Hill, PA 17011 Via original ervice of process to: Herbert I. Soller, M.D. 7 Saratoga Place Camp Hill, PA 17011 Via certified mail return receipt to: Medicore,Inc. 2647 West 81" Street Hialeah, FL 33016 James Prahler, Esquire Margolis Edelstein Independence Square West 6th & Walnut Streets, 4th Floor Philadelphia, PA 19103 Andrea J. Shaer, M.D. 5354 Bay Hill Drive Canfield, OH 44406 L SER & FREIWALD, P.C. BY: N J. FREIWALD, SQUIItE Dated: -4?1 29 IMAGED -- o JANET ARONSON, as Administratrix of the Estate of STEPHEN-J. ARONSON, Deceased, Plaintiff V. JONATHAN R. DIAMOND, M.D., ANDREA J. SHAER, M.D., HERSHEY KIDNEY SPECIALISTS, INC., HOLY SPIRIT HOSPITAL, HOLY SPIRIT HEALTH SYSTEMS, PHILIP MAGUIRE, M.D., AMY M. FAJARDO, M.D., DIALYSIS CORPORATION OF AMERICA-LEMOYNE, MEDICORE, INC. and HERBERT I. SOLLER, M.D., Defendants IN THE COURT OF COMMON PLEAS DAUPHIN COUNTY, PENNSYLVANIA NO. 2005 CV 2701 MM CIVIL ACTION - LAW MEDICAL MALPRACTICE ACTION JURY TRIAL DEMANDED ORDER AND NOW, this ? day of OQ Ue M b or 2005, upon consideration of the Joint Preliminary Objection to Plaintiffs Second Amended Complaint of Defendants, Jonathan R. Diamond, M.D., Andrea J. Shaer, M.D., Hershey Kidney Specialists, Inc., Holy Spirit Hospital, Holy Spirit Health System, Philip MacGuire, M.D. and Amy M. Fajardo, M.D., it is hereby ORDERED and DECREED that said Preliminary Objection is SUSTAINED. Venue is hereby transferred to the Court of Common Pleas of Cumberland County, Pennsylvania. Costs and fees for transfer and removal of the record shall be paid by Plaintiff. NOV 2 3 2005 tru BY E COURT: ® "''->! 'R 31 Frottr J. Distribution: Aaron J. Freiwald, Esquire, Layser & Freiwald, P.C., 1500 Walnut Street, 18th Floor, Philadelphia, Pa 19102 Andrew H. Foulkrod, Esquire, Foulkrod Ellis, 2010 Market Street, Camp Hill, Pa 17011 Michael C. Mongiello, Esquire, Foulkrod Ellis, 2010 Market Street, Camp Hill, Pa 17011 Peter J. Curry, Esquire, Thomas Thomas & Hafer, LLP, 305 North Front Street, P.O. Box 999, Harrisburg, PA 17108 Thomas M. Chairs, Esquire, Dickie, McCamey & Chilcote, 1200 Camp Hill Bypass, Suite 202, Camp Hill, Pa 17011 James Prahler, Esquire, Margolis Edelstein, The Curtis Center, 4th Floor, Independence Square West, Philadelphia, Pa 19106-3304 n x L C Commonwealth of Pennsylvania County of Cumberland WRIT OF SUMMONS JANET ARONSON, ADMINISTRATRIX OF THE ESTATE OF STEPHEN J ARONSON,DECEASED 34 GREENMONT DRIVE ENOLA, PA 17025 Plaintiff Vs. BARBARA A. LITTLE, N.P. 1740 TOWPATH ROAD DAUPHIN, PA 17018 AND THOMAS W. ALDOUS, M.D. 503 N. 21sT STREET CAMP HILL, PA 17011 AND DIALYSIS CORPORATION OF AMERICA 27 MILLER STREET LEMOYNE, PA 17043 Defendant Court of Common Pleas No. 05-6393 CIVIL TERM In CivilAction-Law To BARBARA A. LITTLE, N.P., AND THOMAS W. ALDOUS, M.D. AND DIALYSIS CORPORATION OF AMERICA, You are hereby notified that JANET ARONSON, ADMINISTRATRIX OF THE ESTATE OF STEPHEN J. ARONSON, DECEASED, the Plaintiff has / have commenced an action in Civil Action-Law against you which you are required to defend or a default judgment maybe entered against you. (SEAL) Date DECEMBER 15, 2005 Prot onotary By Deputy Attorney: Name: AARON J. FRIEWALD, ESQUIRE Address: LAYSER & FREIWALD, P.C. 1500 WALNUT STREET, 18TH FLOOR PHILADELPHIA, PA 19102 Attorney for: Plaintiff Telephone: 215-875-8000 Supreme Court ID No. 78028 ??, ??; ? ? ?X C') C_ LAYSER & FREIWALD, P.C. By: Aaron J. Freiwald, Esquire aif(f) lavserfreiwald.com Attorney I.D. No. 78028 1500 Walnut Street, 18"Floor Philadelphia, PA 19102 (215) 875-8000 Attorney for Plaintiffs 'L11T' r 1 N O O C_ ?nw lD -o JANET ARONSON, Administratrix of the Estate of STEPHEN J. ARONSON, deceased 34 Greenmont Drive Enola, PA 17025, Plaintiffs, V. BARBARA A. LITTLE, N.P. 1740 Towpath Road Dauphin, PA 17018 and THOMAS W. ALDOUS, M.D. 503 N. 21st Street Camp Hill, PA 17011 and COURT OF COMMON PLEAS OF CUMBERLAND COUNTY NO.: 05-6393 JURY TRIAL DEMANDED CIVIL ACTION - COMPLAINT [MEDICAL MALPRACTICE 2M] NOTICE You have been sued in court If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this complaint and notice are served, by entering a written appearance personally or by attorney and filing in writing with the court your defenses or objections to the claims set forth against you. You we warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by the court without further notice for any money claimed in the complaint or for any other claim or relief requested by the plaintiff. You may lose money or property or other rights important to you. You should take this paper to your lawyer at once. If you do not have a lawyer or cannot afford one, go to or telephone the office set forth below to find out where you can get legal help. Cumberland County Bar Association 32 Saith Bedford Street Carlisle, PA 17013 717-249-3166 AVISO Le ban demandado a usted en la torte. Si usted quiere defenderse de estas demandas expuestas en In paginas siguientes, useted time veinte (20) dias de pla;o al partir de la fmha de la demanda y la notification. Hace flats asentar una comparencia escrita o en persona o con un abogado y entregar a la torte en forma escrita sus defenses o sus objeciones a In demandas en contra de in persona. Sea avisado que si usted no se defiende, la torte comas medidas y puede continuar la demanda en contra suya sin previo aviso o notification. Ademas, la puede decidir a favor del demandante y requiem que usted cumpla con todas In provisiones de esta demanda. Usted puede perm d nem o sus propiedades u ostros derechos importantes pare usted. Lieve esta demanda a on abogado inmediatamente. Si no tiene abogado o si no time el dinem suficiente de pagar tal servicio. Voya en persona o Ilame por telefono a la oficina cuya direction se encuentra escrita abajo para averiguar donde se puede conseguir asisteneia legal. Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 717-249-3166 DIALYSIS CORPORATION OF AMERICA: 27 Miller Street Lemoyne, PA 17043 Defendants COMPLAINT Plaintiff Janet Aronson is the Administratrix of the Estate of Stephen J. Aronson, deceased. 2. Mrs. Aronson is an adult citizen of the Commonwealth of Pennsylvania, residing at 34 Greenmont Drive, Enola, Pennsylvania 17025. Plaintiff's decedent, Stephen J. Aronson, was born on April 11, 1949 and died on February 24, 2004 at age 54. 4. Defendant Barbara A. Little, N.P. ("Nurse Little") is a nurse practitioner, licensed in the Commonwealth of Pennsylvania, who maintained professional offices at 4700 Union Deposit Road, Suite 240, Harrisburg, Pennsylvania 17111. Plaintiff is asserting a professional liability action against this defendant. Defendant Thomas W. Aldous, M.D. ("Dr. Aldous") is a physician, licensed in the Commonwealth of Pennsylvania, who maintained professional offices at Holy Spirit Hospital, at 503 N. 21" Street, Camp Hill, Pennsylvania 17011. Plaintiff is asserting a professional liability action against this defendant. 6. Defendant Dialysis Corporation of America ("Dialysis Corp.") is a corporation or other legal entity, organized and operating under the laws of the Commonwealth of Pennsylvania, that, at all relevant times, owned and operated a facility located at 27 Miller Street, Lemoyne, Pennsylvania 17043. Plaintiff is asserting a professional liability action against this defendant. At all relevant times, Nurse Little was an agent or employee of Hershey Kidney Specialists. 8. At all relevant times, Dr. Aldous was an agent, servant, employee and/or ostensible agents of Holy Spirit Hospital. 9. At all relevant times, defendant Dialysis Corp. acted through the conduct of its employees, including but not limited to physicians, dialysis technicians, nurses and other staff in rendering medical care and treatment to patients such as Stephen Aronson. 10. At all relevant times, all defendants owed a duty of care to Stephen J. Aronson. 11. Each defendant deviated from accepted standards of care, as set forth more particularly below. 12. As a direct result of the negligence of defendants, individually and jointly together, Stephen J. Aronson was caused to suffer serious personal and other injuries, including, ultimately, his death. 13. Plaintiff Stephen J. Aronson had a history of diabetes and kidney failure. 14. In 2003, Mr. Aronson had placed a dialysis shunt in his left arm in anticipation of dialysis. 15. Mr. Aronson underwent his first dialysis treatment on January 24, 2004 at Dialysis Corp., in Lemoyne, Pennsylvania. 16. Mr. Aronson was not seen or evaluated or counseled by a physician during his time at dialysis on January 24, 2004. 17. On January 26, 2004 at approximately 5:15 p.m., Mr. Aronson presented to the emergency department of Holy Spirit Hospital complaining of shortness of breath lasting several hours. 18. Mr. Aronson also complained on arrival to the emergency department of a diminished level of consciousness and decreased memory for the previous 24 hours, as well as right arm soreness. 19. On triage, it was noted that Mr. Aronson had an elevated temperature to 100.4, blood pressure pf 141/55, pulse of 92, respirations of 18, and a pulse ox of only 87 percent on room air. 20. The triage nurse also noted that Mr. Aronson was complaining of difficulty swallowing and of bleeding from the dialysis shunt in his right arm. 21. Dr. Philip Maguire, the attending emergency department physician, evaluated Mr. Aronson at approximately 6:25 p.m. on January 26, 2004 and ordered, among other things, Lasix for Mr. Aronson's shortness of breath. 22. Dr. Maguire ordered an EKG, chest x-ray, IV fluids, blood work and blood cultures. 23. Mr. Aronson's chest x-ray showed evidence of congestive heart failure. 24. Mr. Aronson's EKG showed a normal sinus rhythm. 25. The results of Mr. Aronson's complete blood count (CBC) showed an elevated white count with a marked left shift. 4 26. Mr. Aronson's nephrologist, Dr. Jonathan Diamond was consulted at approximately 8:35 p.m. by telephone, but apparently Dr. Diamond did not come to see his patient in the hospital. 27. No antibiotics were given in the emergency department. 28. Defendant Dr. Aldous also was attending physician in the emergency department at Holy Spirit Hospital on January 26, 2004. 29. Dr. Aldous saw Mr. Aronson in the ER on January 26, 2004. 30. Dr. Aldous was aware of Mr. Aronson's medical history, the complaints that led him to seek emergency medical attention and the treatment he has received in the ER. 31. Dr. Aldous consulted with Dr. Diamond, apparently by telephone. 32. Dr. Aldous did not insist on or arrange for a face-to-face consultation by Dr. Diamond or another appropriate specialist. 33. At approximately 11:00 p.m., Dr. Aldous discharged Mr. Aronson from the ER. 34. Dr. Aldous wrote an "addendum" to Mr. Aronson's medical chart, which proparts to summarize Dr. Aldous' involvement in Mr. Aronson's care and which is dated February 11, 2004. 35. Even though Dr. Aldous' note is dated a significant period of time later, he makes no mention of evaluating Mr. Aronson's dialysis shunt site. 36. Mr. Aronson was discharged to home from the emergency department with instructions to follow up with his scheduled dialysis appointment the following day. 37. On January 27, 2004, Mr. Aronson presented for dialysis at the Dialysis Corp. in Lemoyne. 38, During Mr. Aronson's dialysis treatment, a call was received from Dr. Diamond notifying the dialysis center that Mr. Aronson's blood cultures taken the previous evening at Holy Spirit Hospital were positive. 39. Dr. Diamond gave telephone orders for Mr. Aronson to be given Vancomycin and Gentamycin, two antibiotic medications. 40. Dr. Diamond further ordered that Mr. Aronson be given additional Vancomycin at his regularly scheduled dialysis appointment, on January 29, 2004. 41. Nurse Little saw Mr. Aronson at the Dialysis center on January 27, 2004, Nurse Little noted Mr. Aronson to be "very lethargic." 42. Nurse Little communicated with Dr. Diamond by telephone, but did not arrange for Mr. Aronson to be seen by a physician or to be transferred to the hospital. 43. During dialysis on January 27, 2004, blood was drawn for a CBC. 44. Mr. Aronson was not seen or evaluated or counseled by any physician at the dialysis session on January 27, 2004. 45. The results of the CBC from January 27, 2004, were available the following day and revealed a white count of greater than 22,000. 46. The CBC results were sent by telefax on January 28, 2004 to Hershey Kidney Specialists with a request for antibiotic orders. 47. Blood culture results from January 27, 2004 confirmed the culture results from January 26, 2004 at Holy Spirit Hospital, which had showed the presence of bacteria in Mr. Aronson's blood. 48. On January 28, 2004, Dr. Andrea Shaer another nephrologist with Hershey Kidney Specialists, communicated orders to defendant Dialysis Corp. that Mr. Aronson be given Vancomycin every other treatment for three weeks and Gentamycin on January 29, 2004 and January 31, 2004. 49. Mr. Aronson returned for dialysis to the Dialysis Corp. on January 29, 2004. 50. During dialysis on January 29, 2004, Mr. Aronson complained of shortness of breath and had a blood pressure of 94 over 50. 51. Per Dr. Shaer's orders, Mr. Aronson was given Gentamycin, but he was not given Vancomycin at the time of dialysis on January 29, 2004. 52. Mr. Aronson was not seen or evaluated or counseled by a physician at the dialysis session on January 29, 2004. 53. On January 29, 2004, Mr. Aronson returned to the emergency department at Holy Spirit Hospital now complaining of memory loss, intermittent shakes, pale skin and feeling like he has "been out of it." 54. In the ER on January 29, 2004, Mr. Aronson was seen by Dr. Amy Fajardo, an attending emergency department physician, whose impression was that Mr. Aronson had altered mental status and hypoglycemia. 55. A CBC performed on January 29, 2004 showed, again, an elevated white count with a left shift. 56. Dr. Fajardo ordered blood cultures. 57. Approximately two hours after Mr. Aronson presented to the emergency department, Dr. Fajardo ordered that he be discharged to home. 7 58. On January 30, 2004, Mr. Aronson presented to Dialysis Corp. for another dialysis treatment. 59. On January 30, 2004, Dr. Shaer again changed Mr. Aronson's antibiotics orders, now ordering that he be continued on Vancomycin, but that the Gentamycin be discontinued. 60. Mr. Aronson received no antibiotics during his dialysis session on January 30, 2004. 61. Mr. Aronson was not seen or evaluated or counseled by a physician during the dialysis session on January 29, 2004. 61. On January 31, 2004, Mr. Aronson was admitted to Holy Spirit Hospital with severe arm pain and labored breathing. 62. Mr. Aronson died on February 24, 2004, of complications from sepsis. 63. As a result of the negligence of defendants, plaintiff Stephen J. Aronson suffered the following injuries and losses; (a) wrongful death; (b) ischemic right arm; (c) overwhelming sepsis; (d) endocarditis; (e) extensive hospitalization and multiple surgeries; (f) physical pain and suffering; (g) mental anguish; (h) embarrassment and disfigurement; (i) loss of past earnings; 8 0) loss of future earnings; (k) medical care costs; and (1) humiliation. 64. In additional to the injuries and losses sustained by Mr. Aronson, plaintiff Janet Aronson is entitled to compensatory damages as set forth further below. FIRST CAUSE OF ACTION: WRONGFUL DEATH ACT Janet Aronson, Individually and as Administratrix of the Estate of Stephen J. Aronson v. All Defendants 65. The preceding paragraphs are incorporated by reference as though set forth in their entirety here. 66. Janet Aronson, Administratrix of the Estate of Stephen J. Aronson, brings this action on behalf of the beneficiaries under and by virtue of the Wrongful Death Act, 42 Pa.C.S.A. § 8301, and the applicable Rules of Civil Procedure and decisional law. 67. Janet Aronson, Administratrix of the Estate of Stephen J. Aronson, claims all Administratrix's expenses recoverable under the Wrongful Death Act, including, but not limited to, damages for hospital, medical, funeral and burial expenses and all expenses of administration made necessary because of Stephen J. Aronson's death. 68. The Wrongful Death Act beneficiaries are: a. Janet Aronson (wife). b. Jonathan Aronson (minor son); and c. Mitchell Aronson (minor son.) 69. On behalf of the Wrongful Death beneficiaries, the Administratrix claims damages for monetary support that decedent would have provided to the beneficiaries during his lifetime, including, but not limited to, the support provided or which could have been expected to have been provided to the beneficiaries. 70. On behalf of the Wrongful Death Act beneficiaries, the Administratrix claims damages for loss of companionship, comfort, society, guidance, solace, and protection by the decedent. 71. On behalf of the Wrongful Death beneficiaries, the Administratrix claims damages for the full damages allowed under the Wrongful Death Act of Pennsylvania and decisional law interpreting that Act. WHEREFORE, plaintiff demands damages against defendants, jointly and severally, in an amount in excess of $50,000, and in excess of the prevailing arbitration limits under the Wrongful death Act, exclusive of pre-judgment interest, post judgment interest and costs. SECOND CAUSE OF ACTION: SURVIVAL ACTION Janet Aronson, Individually and as Administratrix of the Estate of Stephen J. Aronson v. All Defendants 72. The previous paragraphs are incorporated herein by reference. 73. Janet Aronson, as Administratrix of the Estate of Stephen J. Aronson, brings this Survival Action on behalf of Stephen J. Aronson, under and by virtue of 41 Pa. C.S.A. § 8302 and the applicable Rules of Civil Procedure and decisional law. 74. As a result of the negligent acts and omissions of defendants, Stephen J. Aronson was caused grave injuries and death resulting in the entitlement to damages to the Estate of Stephen J. Aronson, Deceased. 10 75. On behalf of the Survival Act beneficiaries, the Administratrix claims loss of earnings and economic loss of decedent's estate, including, but not limited to, Stephen J. Aronson's total estimated future earnings less the cost of his personal maintenance. 76. On behalf of the Survival Act beneficiaries, the Administratrix claims all loss of income, retirement, and Social Security income as a result of Stephen J. Aronson's death. 77. On behalf of the Survival Act beneficiaries, the Administratrix claims damages for the pain, suffering, and inconvenience endured by Stephen J. Aronson to his death, including, but not limited to his physical pain and suffering, mental pain and suffering. 78. Plaintiff claims the full measure of damages under the Survival Act and decisional law interpreting the Act. WHEREFORE, plaintiff demands damages against defendants, jointly and severally, in an amount in excess of the prevailing arbitration limits under the Survival Act, exclusive of pre- judgment interest, post-judgment interest and costs. COUNT ONE: NEGLIGENCE Plaintiff v. Barbara A. Little, N.P. 79. The preceding paragraphs are incorporated here by reference. 80. The negligence of Nurse Little included the following: (a) failure to appreciate the significance of Mr. Aronson's infection; (b). failure to appreciate the significance of Mr. Aronson's signs and symptoms of infection, including elevated white count and lethergy; (c) failure to timely order antibiotic therapy; (d) failure to transfer Mr. Aronson to the hospital on January 27, 2004; 11 (e) failure to arrange for a physician to see Mr. Aronson in person and evaluate him while he was in the dialysis center on January 27, 2004; (f) failure to appreciate the signs and symptoms of a shunt infection; (g) failure to work up Mr. Aronson for the cause of his infection; (h) failure to appreciate the significance of Mr. Aronson's right arm pain; (i) failure to order appropriate diagnostic studies to work up Mr. Aronson's right arm pain, such as ultrasound or CAT scan; (n) failure to take all reasonable and necessary steps to treat Mr. Aronson's systemic infection. 81. The negligence of Nurse Little was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. COUNT TWO: NEGLIGENCE Plaintiff v. Thomas W. Aldous, M.D. 82. The preceding paragraphs are incorporated hereby reference. 83. The negligence of Dr. Aldous included the following: (a) failure to order that Mr. Aronson be admitted to the hospital on January 26, 2004; (b) failure to request an in-person consultation by an appropriate specialist, such as a nephrologist or an infectious disease physician; (c) negligent discharging of Mr. Aronson from the emergency department on January 26,2004; 12 (d) failure to appreciate the significance of Mr. Aronson's signs and symptoms on January 26, 2004, including his elevated white count, his level of consciousness, his right arm pain and other indications of infection; (e) failure to perform a through examination, including an assessment of Mr. Aronson's right arm; (f) failure to communicate appropriately with Dr. Diamond so as to convey the seriousness of Mr. Aronson's condition; (g) failure to appreciate the gravity of Mr. Aronson's medical condition on January 26, 2004; (h) failure to appreciate the critical nature of Mr. Aronson's infection on January 26, 2004; (i) failure to order appropriate antibiotic therapy to be administered in the hospital on January 26, 2004 and thereafter; and 0) failure to take all reasonable and necessary steps to treat Mr. Aronson's infection in a timely fashion. 84. The negligence of Dr. Aldous was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. COUNT THREE: NEGLIGENCE Plaintiff v. Dialysis Corporation of America 85. The preceding paragraphs are incorporated by reference. 86. The negligence of Dialysis Corp. included the following: 13 (a) failure to have a physician see and evaluate Stephen J. Aronson while a patient at the dialysis facility; (b) failure to implement physician orders regarding antibiotics; (c) failure to refer Stephen J. Aronson to the emergency department on January 26, 2004, January 29, 2004 and/or January 30, 2004. (d) failure to have a physician or other qualified health care provider counsel the patient regarding potential complications of dialysis, including shunt infection; (e) failure to have a qualified health care provider assess Mr. Aronson, particularly in light of his already-known infection; (f) failure to properly train dialysis technicians and other personnel in how to identify and report to a serious infection; (g) failure to administer proper antibiotics; (h) failure to order a consultation with an appropriate specialist, such as infectious disease; (i) failure to have and enforce treatment protocols for dialysis patients with known infections; and 0) failure to have and enforce proper treatment protocols for patients receiving antibiotics during dialysis. 87. The negligence of the Dialysis Corp. was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. 14 WHEREFORE, plaintiff demands compensatory damages against all defendants, jointly and severally, in an amount in excess of $50,000 and in excess of the prevailing mandatory arbitration limits, exclusive of pre judgment, post judgment interest and costs. LAYSER & FREIWALD, P.C. By: a?-LA O?DORON J. FREIW , ESQUIRE Attorney for Plaintiffs DATED: N 15? d ? 15 VERIFICATION I, JANET ARONSON, Individually and as Administratrix of the Estate of Stephen J. Aronson hereby verify that the facts set forth in the foregoing Complaint is true and correct to the best of our kncwledge, information and belief The undersigned understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities. 44 JANET ARONSON, Individually and as Administratrix of the Estate of Stephen J. Aronson CERTIFICATE OF SERVICE I, AARON J. FREIWALD, ESQUIRE, hereby certify that service of a true and correct copy of the Complaint was served upon opposing counsel on this date, via United State First Class Mail, Postage Prepaid, as follows: Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote 1200 Camp Hill Bypass Suite 202 Camp Hill, PA 17011-3700 Michael C. Mongiello, Esquire Foulkrod Ellis 2010 Market Street Camp Hill, PA 17011 James Prahler, Esquire Margolis Edelstein Independence Square West 6th & Walnut Streets, 4th Floor Philadelphia, PA 19103 Peter J. Curry, Esquire Thomas, Thomas & Hafer 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 LAYSER & FREIWALD, P.C. BY: AARON J. FREIWALD, ESQUIRE Attorney for Plaintiffs DATED: 16 . , JANET ARONSON, Executrix Of the Estate of STEPHEN J. ARONSON, deceased Plaintiffs V. JONATHAN R. DIAMOND, M.D., et al JANET ARONSON, Executrix Of the Estate of STEPHEN J. ARONSON, deceased Plaintiffs V. BARBARA A. LITTLE, N.P., et al IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 06-111 CIVIL IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 05-6393 CIVIL ORDER OF COURT AND NOW, this 16`h day of February, 2006, upon consideration of the Plaintiff's Motion, a Rule is hereby issued on all defendants to show cause why the above captioned cases should not be consolidated; (1) The defendants shall file an answer to the petition within 20 days of service; (2) The petition shall be decided under Pa.R.C.P. No. 206.7; (3) An evidentiary hearing on disputed issues of material fact shall be held on the 28th day of March, 2006, at 2:00 p.m. in Courtroom No. 5 of the Cumberland County Courthouse. By the Court, 1?\ t M. L. Ebert, Jr., J. Aaron J. Freiwald, Esquire Attorney for Plaintiff Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote 1200 Camp Hill Bypass Suite202 Camp Hill, PA 17011 Michael C. Mongiello, Esquire Foulkrod Ellis 2010 Market Street Camp Hill, PA 17011 James Prahler, Esquire Margolis Edelstein Independence Square West G6?ec A 61° & Walnut Streets, 4" Floor ee Philadelphia, PA 19103 Peter J. Curry, Esquire Thomas, Thomas & Hafer 305 North Front Street P. O. Box 999 Harrisburg, PA 17108 has MARGOLIS EDELSTEIN BY: JAMES M. PRAHLER, ESQUIRE Identification No. 54703 The Curtis Center, 4m Floor 601 Walnut Street Philadelphia, PA 19106 215-922-1100 Attorney for Defendant, Dialysis Corporation of America JANET ARONSON, Administratrix of the Estate of STEPHEN J. ARONSON, Deceased V. BARBARA LITTLE, N.P., THOMAS W. ALDOUS, M.D. AND DIALYSIS CORPORATION OF AMERICA COURT OF COMMON PLEAS CUMBERLAND COUNTY NO. 05-6393 JANET ARONSON, Administratrix of the Estate of STEPHEN J. ARONSON, Deceased V. JONATHAN A. DIAMOND. M.D., et al COURT OF COMMON PLEAS CUMBERLAND COUNTY NO. 06-111 REPLY OF DEFENDANTS, DIALYSIS CORPORATION OF AMERICA AND DIALYSIS CORPORATION OF AMERICA-LEMOYNE TO PLAINTIFF'S MOTION TO CONSOLIDATE CASES 1. Admitted. 2. Admitted. 3. Admitted. 4. Admitted based upon information and belief. 5. The respondents do not have information as to the basis of the Complaint that was filed in the Cumberland County Court of Common Pleas on M December 12, 2005. 6. Admitted. 7. It is admitted that the two related actions should be consolidated for discovery and trial. 8. Admitted. 9. Admitted. 10. Admitted. 11. Admitted. It is suggested to the Court that the interest of justice would be best served by consolidation of the two cases. 12. Admitted. In addition, the claims set forth in the civil cases relate to alleged wrongful death and survival and should, of necessity, be consolidated. 13. Admitted. WHEREFORE, the defendants, Dialysis Corporation of America and Dialysis Corporation of America-Lemoyne, respectfully request the Court to grant the Plaintiff's Motion to Consolidate the above entitled civil cases. Respectfully submitted, MARGOLIS EDELSTEIN BY:r ES M. PRAHLER, ESQUIRE Attorney for Defendants, Dialysis Corporation of America and Dialysis Corporation of America-Lemoyne I, JAMES M. PRAHLER, ESQUIRE, hereby certify that a true and correct copy of Defendants, Dialysis Corporation of America and Dialysis Corporation of America-Lemoyne was served upon the following counsel of record by regular mail, postage prepaid: Aaron J. Freiwald, Esquire LAYSER & FREIWALD, P.C. 1500 Walnut Street - 18th Floor Philadelphia, PA 19102 Peter J. Curry, Esquire Thomas Thomas & Hafer 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 Michael C. Mongiello, Esquire Foulkrod Ellis 2010 Market Street Camp Hill, PA 17011 Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote, PC 1200 Camp Hill Bypass, Suite 205 Camp Hill, PA 17011 MARGOLIS EDELSTEIN JAMES IVI. PRAHLER, ESQUIRE DATE:,' - 15 - t/C -r? i FOULKROD ELLIS Professional Corporation 2010 Market Street Camp Hill, PA 17011 Phone: (717) 909-7006 Attorney for Defendant: Fax: (717) 909-6955 Barbara A. Little. N.P. JANET ARONSON, as Administratrix of the : IN THE COURT OF COMMON PLEAS Estate of STEPHEN J. ARONSON, : CUMBERLAND COUNTY, PENNSYLVANIA Deceased, Plaintiff NO. 05-6393 V. CIVIL ACTION - LAW BARBARA A. LITTLE, N.P., THOMAS W. ALDOUS, M.D. and DIALYSIS CORPORATION OF AMERICA, Defendants JURY TRIAL DEMANDED PRELIMINARY OBJECTION TO PLAINTIFF'S AMENDED COMPLAINT OF DEFENDANT, BARBARA A. LITTLE, N.P. AND NOW comes Defendant, Barbara A. Little, N.P. ("Nurse Little"), by and through her counsel, Foulkrod Ellis, and preliminarily objects to Plaintiff's Complaint as follows: Counsel for Defendant, Barbara A. Little, N.P. ("Nurse Little") advised Plaintiff's counsel by correspondence of December 27, 2005 that although Nurse Little is currently a Nurse Practitioner, she was at all times relevant to this lawsuit a Professional Nurse. A copy of said letter is attached hereto as Exhibit "I". 2. Nurse Little confirmed her relevant status as a Professional Nurse in an Affidavit attached to her Preliminary Objection to Plaintiff's Complaint. A copy of said Affidavit is attached hereto as Exhibit "211 . In response to Nurse Little's Preliminary Objection, Plaintiff filed an Amended Complaint on February 3, 2006, therein attempting to remedy the objected-to allegations. A copy of Plaintiff's Amended Complaint is attached hereto as Exhibit "3". 4. Despite Nurse Little's Affidavit, Plaintiff fails to concede in the Amended Complaint that Nurse Little was not a Nurse Practitioner during the relevant timeframe (see Exhibit "3", p. 2, ¶ 4) and again makes averments that are objectionable as outside the scope of a Professional Nurse's duties (see Exhibit "3", pp. 11-12). See Supporting Brief. WHEREFORE, it is respectfully requested that this Honorable Court enter the attached Order. Respectfully submitted, FOULKROD ELLIS PROFESSIONAL CORPORATION By: Michael C. Mongiello, Esquire Attorney I.D. No. 87532 Date: February ?L> , 2006 e ?K?) Lit FOULKROD ELLIS P-A"?-d 15-0-fie- ATTORNEYS AND COUNSELORS AT LAW 2010 Market Street CAMP HILL. PENNSYLVANIA 17011 PHONE (717) 909-7006 FAX (717) 909.6955 ANDREW H. FOULKROD December 27, 2005 Aaron J. Freiwald, Esquire Layser & Freiwald, P.C. 1500 Walnut Street -18th Floor Philadelphia, PA 19102 Re: Janet Aronson v. Little. et al. No. 05-6393 (Cumberland County CCP) Dear Mr. Freiwald: PHONE EXTENSION; 4 andraw@foulkrod.oom Responding to your letter of December 22, at all relevant times Nurse Little was an R.N. per my understanding, not a C.R.N.P. Sincerely yyoourfs, ?f Andrew H. Foulkrod' AHF/cag 2 AFFIDAVIT I, Barbara A_ Little, N.P., do hereby swear and affirm under penalties prescribed by law that the following is true and correct to the best of my knowledge, inLortua.tion and belief; 1. At the time of uty involvement in Stephen T. A.ronson's cafe in Januax-y 2004, I was a Registered Professional Nurse and not a Mirep Practitioner. 2. I became a Nurse Practitioner . . after my involvement in Stephen J. Aronson's care, on 424 IZ, 2-004 See Exhibit "1" hereto. Datod! \J ang¢n, 1.2 LCM z l' ^?^ arbara A, Little, N- . Sworn to and subscribed before me this day of ?( t r n l 2306. /1'7_ d v15C-L? o ary Public Notarial Seal Leann M. Beach. Notary Public City of Harrisburg, Dauphin County My Commission Expires Oct. 24, 2006 EXHIBIT 1 i.00 -mot tY tQ ? Jy rrr SdT` -4 i ?a tG y? ?fc ?kk d , N V?v lit ? a kv, +a r tr r ? `-$am 7 T:itCt: r„Y i ?? ? i^aVlSs? . M Alo, £0'd %66 ZZ:2T 9002-BT-Ndf 3 3 LAYSER & FREIWALD, P.C. By: Aaron J. Freiwald, Esquire ajf( lavserfreiwald.com Attorney I.D. No. 78028 1500 Walnut Street, 18th Floor Philadelphia, PA 19102 (215) 875-8000 Attorney for Plaintiffs JANET ARONSON, Administratrix of the Estate of STEPHEN J. ARONSON, deceased Plaintiffs, V. COURT OF COMMON PLEAS OF CUMBERLAND COUNTY BARBARA A. LITTLE, N.P., ET AL. NO.: 05-6393 Defendants JURY TRIAL DEMANDED CIVIL ACTION - AMENDED COMPLAINT [MEDICAL MALPRACTICE 2M] NOTICE You have been sued in court If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this complaint and notice are served, by entering a written appearance personally or by attorney and filing in writing with the court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by the court without further notice for any money claimed in the complaint or for any other claim or relief requested by the plaintiff. You may lose money or property or other rights important to you. You should take this paper to your lawyer at once. If you do not have a lawyer or cannot afford one, go to or telephone the office set forth below to find out where you can get legal help. Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 717-249-3166 AVISO Le ban demandado a usted en Is torte. Si usted quiere defenderse de estas demandas expuestas en las paginas siguientes, useted time veinte (20) dies de pluo al partir de Is fecha de Is demanda y Is notification. Hace flats asentar una comparencia escrita o en persona o con on abogado y entregar a Is carte en forma escrita sus defenses o sus objeciones a his demandas en contra de su persona Sea avisado clue si uswd no se defiende, Is torte tomato medidas y poetic continuar Is demands en contra suya sin previo aviso o notification. Ademas, is poetic decidir a favor del demandante y requiere que usted cumpla con Codas lea provisions de esta demands. U$ted puede peter diners o sus propiedades u ostros derechos importantes pats usted. Lieve esta demands a on abogado inmediatamente. Si no dene abogado o A no Ilene el diners suliciente de pagar tal serviclo. Vaya an persona o Bame por telefono a Is oficina toys direction se encuentra escrita abaJo para averiguar donde se puede conseguir asistencia legal. Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 717-249-3166 AMENDED COMPLAINT 1. Plaintiff Janet Aronson is the Administratrix of the Estate of Stephen J. Aronson, deceased. 2. Mrs. Aronson is an adult citizen of the Commonwealth of Pennsylvania, residing at 34 Greenmont Drive, Enola, Pennsylvania 17025. 3. Plaintiff's decedent, Stephen J. Aronson, was born on April 11, 1949 and died on February 24, 2004 at age 54. 4. Defendant Barbara A. Little, N.P. ("Nurse Little") is a nurse practitioner, licensed in the Commonwealth of Pennsylvania, who maintained professional offices at 4700 Union Deposit Road, Suite 240, Harrisburg, Pennsylvania 17111. Plaintiff is asserting a professional liabil'i action against this defendant. 5. Defendant Thomas W. Aldous, M.D. ("Dr. Aldous") is a physician, licensed in the Commonwealth of Pennsylvania, who maintained professional offices at Holy Spirit Hospital, at 503 N. 2? Street, Camp Hill, Pennsylvania 17011. Plaintiff is asserting a professional liability action against this defendant. 6. Defendant Dialysis Corporation of America ("Dialysis Corp.") is a corporation or other legal entity, organized and operating under the laws of the Commonwealth of Pennsylvania, that, at all relevant times, owned and operated a facility located at 27 Miller Street, Lemoyne, Pennsylvania 17043. Plaintiff is asserting a professional liability action against this defendant. 7. At all relevant times, Nurse Little was an agent or employee of Hershey Kidney Specialists. 2 8. At all relevant times, Dr. Aldous was an agent, servant, employee and/or ostensible agents of Holy Spirit Hospital. At all relevant times, defendant Dialysis Corp. acted through the conduct of its employees, including but not limited to physicians, dialysis technicians, nurses and other staff in rendering medical care and treatment to patients such as Stephen Aronson. 10. At all relevant times, all defendants owed a duty of care to Stephen J. Aronson. 11. Each defendant deviated from accepted standards of care, as set forth more particularly below. 12. As a direct result of the negligence of defendants, individually and jointly together, Stephen J. Aronson was caused to suffer serious personal and other injuries, including, ultimately, his death. 13. Plaintiff Stephen J. Aronson had a history of diabetes and kidney failure. 14. In 2003, Mr. Aronson had placed a dialysis shunt in his left arm in anticipation of dialysis. 15. Mr. Aronson underwent his first dialysis treatment on January 24, 2004 at Dialysis Corp., in Lemoyne, Pennsylvania. 16. Mr. Aronson was not seen or evaluated or counseled by a physician during his time at dialysis on January 24, 2004. 17. On January 26, 2004 at approximately 5:15 p.m., Mr. Aronson presented to the emergency department of Holy Spirit Hospital complaining of shortness of breath lasting several hours. 18. Mr. Aronson also complained on arrival to the emergency department of a diminished level of consciousness and decreased memory for the previous 24 hours, as well as right arm soreness. 19. On triage, it was noted that Mr. Aronson had an elevated temperature to 100.4, blood pressure pf 141/55, pulse of 92, respirations of 18, and a pulse ox of only 87 percent on room air. 20. The triage nurse also noted that Mr. Aronson was complaining of difficulty swallowing and of bleeding from the dialysis shunt in his right arm. 21. Dr. Philip Maguire, the attending emergency department physician, evaluated Mr. Aronson at approximately 6:25 p.m. on January 26, 2004 and ordered, among other things, Lasix for Mr. Aronson's shortness of breath. 22. Dr. Maguire ordered an EKG, chest x-ray, IV fluids, blood work and blood cultures. 23. Mr. Aronson's chest x-ray showed evidence of congestive heart failure. 24. Mr. Aronson's EKG showed a normal sinus rhythm. 25. The results of Mr. Aronson's complete blood count (CBC_') showed an elevated white count with a marked left shift. 26. Mr. Aronson's nephrologist, Dr. Jonathan Diamond was consulted at approximately 8:35 p.m. by telephone, but apparently Dr. Diamond did not come to see his patient in the hospital 27. Ne antibiotics were given in the emergency department. 4 28. Defendant Dr. Aldous also was attending physician in the emergency department at Holy Spirit Hospital on January 26, 2004. 29. Dr: Aldous saw Mr. Aronson in the ER on January 26, 2004. 30. - Dr. Aldous was aware of Mr. Aronson's medical history, the complaints that led him to seek emergency medical attention and the treatment he has received in the ER. 31. Dr. Aldous consulted with Dr. Diamond, apparently by telephone. 32. Dr. Aldous did not insist on or arrange for a face-to-face consultation by Dr. Diamond or another appropriate specialist. 33. At approximately 11:00 p.m., Dr. Aldous discharged Mr. Aronson from the ER. 34. Dr. Aldous wrote an "addendum" to Mr. Aronson's medical chart, which proparts to summarize Dr. Aldous' involvement in Mr. Aronson's care and which is dated February 11, 2004. 35. Even though Dr. Aldous' note is dated a significant period of time later, he makes no mention of evaluating Mr. Aronson's dialysis shunt site. 36. Mr. Aronson was discharged to home from the emergency department with instructions to follow up with his scheduled dialysis appointment the following day. 37. On January 27, 2004, Mr. Aronson presented for dialysis at the Dialysis Corp. in Lemoyne. 38. During Mr. Aronson's dialysis treatment, a call was received from Dr. Diamond notifying the dialysis center that Mr. Aronson's blood cultures taken the previous evening at Holy Spirit Hospital were positive. 5 39. Dr. Diamond gave telephone orders for Mr. Aronson to be given Vancomycin and Gentamycin, two antibiotic medications. 40. Dr. Diamond further ordered that Mr. Aronson be given additional Vancomycin at his regularly scheduled dialysis appointment, on January 29, 2004. 41. Nurse Little saw Mr. Aronson at the Dialysis center on January 27, 2004, Nurse Little noted Mr. Aronson to be "very lethargic." 42. Nurse Little communicated with Dr. Diamond by telephone, but did not arrange for Mr. Aronson to be seen by a physician or to be transferred to the hospital. 43. During dialysis on January 27, 2004, blood was drawn for a CBC. 44. Mr. Aronson was not seen or evaluated or counseled by any physician at the dialysis session on January 27, 2004. 45. The results of the CBC from January 27, 2004, were available the following day and revealed a white count of greater than 22,000. 46. The CBC results were sent by telefax on January 28, 2004 to Hershey Kidney Specialists with a request for antibiotic orders. 47. Blood culture results from January 27, 2004 confirmed the culture results from January 26, 2004 at Holy Spirit Hospital, which had showed the presence of bacteria in Mr. Aronson's blood. 48. On January 28, 2004, Dr. Andrea Shaer another nephrologist with Hershey Kidney Specialists, communicated orders to defendant Dialysis Corp. that Mr. Aronson be given Vancomycin every other treatment for three weeks and Gentamycin on January 29, 2004 and January 31, 2004. 49. Mr. Aronson returned for dialysis to the Dialysis Corp. on January 29, 2004. 50. During dialysis on January 29, 2004, Mr. Aronson complained of shortness of breath and had a blood pressure of 94 over 50. 51. Per Dr. Shaer's orders, Mr. Aronson was given Gentamycin, but he was not given Vancomycin at the time of dialysis on January 29, 2004. 52. Mr. Aronson was not seen or evaluated or counseled by a physician at the dialysis session on January 29, 2004. 53. On January 29, 2004, Mr. Aronson returned to the emergency department at Holy Spirit Hospital now complaining of memory loss, intermittent shakes, pale skin and feeling like he has "been out of it." 54. In the ER on January 29, 2004, Mr. Aronson was seen by Dr. Amy Fajardo, an attending emergency department physician, whose impression was that Mr. Aronson had altered mental status and hypoglycemia. 55. A CBC performed on January 29, 2004 showed, again, an elevated white count with a left shift. 56. Dr. Fajardo ordered blood cultures. 57. Approximately two hours after Mr. Aronson presented to the emergency department, Dr. Fajardo ordered that he be discharged to home. 58. On January 30, 2004, Mr. Aronson presented to Dialysis Corp. for another dialysis treatment. 59. On January 30, 2004, Dr. Shaer again changed Mr. Aronson's antibiotics orders, now ordering that he be continued on Vancomycin, but that the Gentamycin be discontinued. 60. Mr. Aronson received no antibiotics during his dialysis session on January 30, 2004. 61. Mr. Aronson was not seen or evaluated or counseled by a physician during the dialysis session on January 29, 2004. 61. On January 31, 2004, Mr. Aronson was admitted to Holy Spirit Hospital with severe arm pain and labored breathing. 62. Mr. Aronson died on February 24, 2004, of complications from sepsis. 63. As a result of the negligence of defendants, plaintiff Stephen J. Aronson suffered the following injuries and losses; (a) wrongful death; (b) ischemic right arm; (c) overwhelming sepsis; (d) endocarditis; (e) extensive hospitalization and multiple surgeries; (f) physical pain and suffering; (g) mental anguish; (h) embarrassment and disfigurement; (i) loss of past earnings; 0) loss of future earnings; (k) medical care costs; and (1) humiliation. 8 64. In additional to the injuries and losses sustained by Mr. Aronson, plaintiff Janet Aronson is entitled to compensatory damages as set forth further below. FIRST CAUSE OF ACTION: WRONGFUL DEATH ACT Janet Aronson, Individually and as Administratrix of the Estate of Stephen J. Aronson v. All Defendants 65. The preceding paragraphs are incorporated by reference as though set forth in their entirety here. 66. Janet Aronson, Administratrix of the Estate of Stephen J. Aronson, brings this action on behalf of the beneficiaries under and by virtue of the Wrongful Death Act, 42 Pa.C.S.A. § 8301, and the applicable Rules of Civil Procedure and decisional law. 67. Janet Aronson, Administratrix of the Estate of Stephen J. Aronson, claims all Administratrix's expenses recoverable under the Wrongful Death Act, including, but not limited to, damages for hospital, medical, funeral and burial expenses and all expenses of administration made necessary because of Stephen J. Aronson's death. 68. The Wrongful Death Act beneficiaries are: a. Janet Aronson (wife). b. Jonathan Aronson (minor son); and c. Mitchell Aronson (minor son.) 69. On behalf of the Wrongful Death beneficiaries, the Administratrix claims damages for monetary support that decedent would have provided to the beneficiaries during his lifetime, including, but not limited to, the support provided or which could have been expected to have been provided to the beneficiaries. 70. On behalf of the Wrongful Death Act beneficiaries, the Administratrix claims damages for loss of companionship, comfort, society, guidance, solace, and protection by the decedent. 71. On behalf of the Wrongful Death beneficiaries, the Administratrix claims damages for the full damages allowed under the Wrongful Death Act of Pennsylvania and decisional law interpreting that Act. WHEREFORE, plaintiff demands damages against defendants, jointly and severally, in an amount in excess of $50,000, and in excess of the prevailing arbitration limits under the Wrongful death Act, exclusive of pre-judgment interest, post-judgment interest and costs. SECOND CAUSE OF ACTION: SURVIVAL ACTION Janet Aronson, Individually and as Administratrix of the Estate of Stephen J. Aronson v. All Defendants 72. The previous paragraphs are incorporated herein by reference. 73. Janet Aronson, as Administratrix of the Estate of Stephen J. Aronson, brings this Survival Action on behalf of Stephen J. Aronson, under and by virtue of 41 Pa. C.S.A. § 8302 and the applicable Rules of Civil Procedure and decisional law. 74. As a result of the negligent acts and omissions of defendants, Stephen J. Aronson was caused grave injuries and death resulting in the entitlement to damages to the Estate of Stephen J. Aronson, Deceased. 75. On behalf of the Survival Act beneficiaries, the Administratrix claims loss of earnings and economic loss of decedent's estate, including, but not limited to, Stephen J. Aronson's total estimated future earnings less the cost of his personal maintenance. 10 76. On behalf of the Survival Act beneficiaries, the Administratrix claims all loss of income, retirement, and Social Security income as a result of Stephen J. Aronson's death. 77. On behalf of the Survival Act beneficiaries, the Administratrix claims damages for the pain, suffering, and inconvenience endured by Stephen J. Aronson to his death, including, but not limited to his physical pain and suffering, mental pain and suffering. 78. Plaintiff claims the full measure of damages under the Survival Act and decisional law interpreting the Act. WHEREFORE, plaintiff demands damages against defendants, jointly and severally, in an amount in excess of the prevailing arbitration limits under the Survival Act, exclusive of pre- judgment interest, post judgment interest and costs. COUNT ONE: NEGLIGENCE Plaintiff v. Barbara A. Little, N.P. 79. The preceding paragraphs are incorporated here by reference. 80. The negligence of Nurse Little included the following: (a) failure to appreciate the significance of Mr. Aronson's infection; (b) failure to appreciate the significance of Mr. Aronson's signs and symptoms of infection, including elevated white count and lethergy; (c) failure to recommend transfer of Mr. Aronson to the hospital on January 27, 2004; (d) failure to arrange for a physician to see Mr. Aronson in person and evaluate him while he was in the dialysis center on January 27, 2004; (e) failure to appreciate the signs and symptoms of a shunt infection; 11 (f) failure to perform a thorough nursing assessment of Mr. Aronson regarding his evident infection; (g) failure to appreciate the significance of Mr. Aronson's right arm pain; and (h) failure to take all reasonable and necessary steps to treat Mr. Aronson's systemic infection. 81. The negligence of Nurse Little was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. COUNT TWO: NEGLIGENCE Plaintiff v. Thomas W. Aldous. M.D. 82. The preceding paragraphs are incorporated hereby reference. 83. The negligence of Dr. Aldous included the following: (a) failure to order that Mr. Aronson be admitted to the hospital on January 26, 2004; (b) failure to request an in-person consultation by an appropriate specialist, such as a nephrologist or an infectious disease physician; (c) negligent discharging of Mr. Aronson from the emergency department on January 26,2004; (d) failure to appreciate the significance of Mr. Aronson's signs and symptoms on January 26, 2004, including his elevated white count, his level of consciousness, his right arm pain and other indications of infection; 12 (e) failure to perform a through examination, including an assessment of Mr. Aronson's right arm; (f) failure to communicate appropriately with Dr. Diamond so as to convey the seriousness of Mr. Aronson's condition; (g) failure to appreciate the gravity of Mr. Aronson's medical condition on January 26, 2004; (h) failure to appreciate the critical nature of Mr. Aronson's infection on January 26, 2004; (i) failure to order appropriate antibiotic therapy to be administered in the hospital on January 26, 2004 and thereafter; and 0) failure to take all reasonable and necessary steps to treat Mr. Aronson's infection in a timely fashion. 84. The negligence of Dr. Aldous was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. COUNT THREE: NEGLIGENCE Plaintiff v. Dialysis CorRooration of America 85. The preceding paragraphs are incorporated by reference. 86. The negligence of Dialysis Corp. included the following: (a) failure to have a physician see and evaluate Stephen J. Aronson while a patient at the dialysis facility; (b) failure to implement physician orders regarding antibiotics; 13 (c) failure to refer Stephen J. Aronson to the emergency department on January 26, 2004, January 29, 2004 and/or January 30, 2004. (d) failure to have a physician or other qualified health care provider counsel the patient regarding potential complications of dialysis, including shunt infection; (e) failure to have a qualified health care provider assess Mr. Aronson, particularly in light of his already-known infection; (f) failure to properly train dialysis technicians and other personnel in how to identify and report to a serious infection; (g) failure to administer proper antibiotics; (h) failure to order a consultation with an appropriate specialist, such as infectious disease; (i) failure to have and enforce treatment protocols for dialysis patients with known infections; and 0) failure to have and enforce proper treatment protocols for patients receiving antibiotics during dialysis. 87. The negligence of the Dialysis Corp, was a substantial factor in causing Mr. Aronson to suffer the injuries and losses described above. 14 WHEREFORE, plaintiff demands compensatory damages against all defendants, jointly and severally, in an amount in excess of $50,000 and in excess of the prevailing mandatory arbitration limits, exclusive of pre judgment, post judgment interest and costs. LAYSER & FREMALD, P.C. By: AARON J. FREIWALD, ESQUIRE Attorney for Plaintiffs DATED: 1A*)%0 15 VERIFICATION 1, AARON J. FREIWALD, ESQUIRE, hereby verify that the facts set forth in the foregoing Amended Complaint are true and correct to the best of our knowledge, information and belief. The undersigned understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities. -(S AARON J. FREIWALD, ESQUIRE CERTIFICATE OF SERVICE I, AARON J. FREIWALD, ESQUIRE, hereby certify that service of a true and correct copy of the Amended Complaint was served upon opposing counsel on this date, via United State First Class Mail, Postage Prepaid, as follows: Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote 1200 Camp Hill Bypass Suite 202 Camp Hill, PA 17011-3700 Michael C. Mongiello, Esquire Foulkrod Ellis 2010 Market Street Camp Hill, PA 17011 James Prahler, Esquire Margolis Edelstein Independence Square West 6th & Walnut Streets, 4th Floor Philadelphia, PA 19103 Peter J. Curry, Esquire Thomas, Thomas & Hafer 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 LAYSER & FREIWALD, P.C. BY: O-Q-t AARON J. FREIWALD, ESQUIRE Attorney for Plaintiffs DATED: /I G} 16 1, Cheryl A. Garofalo, an employee of the law firm of Foulkrod Ellis, P.C., hereby certify that a true and correct copy of the foregoing document was served upon all counsel of record this day of February, 2006, by depositing said copy in the United States Mail at Camp Hill, Pennsylvania, postage prepaid, first class delivery, and addressed as follows: Aaron J. Freiwald, Esquire Layser & Freiwald, P,C. 1500 Walnut Street, 18"' Floor Philadelphia, PA 19102 Attorney for Plaintiff Francis E. Marshall, Jr., Esquire Thomas M. Chairs, Esquire Marcelle M. Theis, Esquire Dickie McCamey & Chilcote, P.C. 1200 Camp Hill Bypass - Suite 205 Camp Hill, PA 17011 Attorneys for Defendant, Thomas W. Aldous, M. D. James M. Prabler, Esquire Margolis Edelstein The Curtis Center, 4`h Floor Independence Square West Philadelphia, PA 1 9 1 06-3 3 04 Attorney for Dialysis Corporation ofAmerica FOULKROD ELLIS PROFESSIONAL CORPORATION By:_ Z- Cheryl A Gar falo ..> -, ;? , ? ; .?, ? ,: ,_,, ?._: t,, __ ,:: FOULKROD ELLIS Professional Corporation 2010 Market Street Camp Hill, PA 17011 Phone: [717] 909-7006 Fax: [717] 909-6955 Attorneys for Defendants: Barbara A. Little, N.P., Jonathan R. Diamond, M.D., Andrea J. Shaer, M.D. and Hershey Kidney Specialists, Inc. JANET ARONSON, as Administratrix of the Estate of STEPHEN J. ARONSON, Deceased, Plaintiffs IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY. PENNSYLVANIA V. JONATHAN R. DIAMOND, M.D., et al., Defendants NO. 06-0111 JANET ARONSON, as Administratrix of the Estate of STEPHEN J. ARONSON, Deceased, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY. PENNSYLVANIA V. BARBARA A. LITTLE, N.P., et al., Defendants NO. 05-6393 ? ANSWER OF DEFENDANTS, BARBARA A. LITTLE, N.P., JONATHAN R. DIAMOND, M.D., ANDREA J, SHAER, M.D. AND HERSHEY KIDNEY SPECIALISTS, INC. TO PLAINTIFFS' MOTION TO CONSOLIDATE CASES AND NOW, come Defendants, Barbara A. Little, N.P., Jonathan R. Diamond, M.D., Andrea J. Shaer, M.D. and Hershey Kidney Specialists, Inc. (hereinafter collectively referred to as "Answering Defendants") and answer Plaintiffs' Motion to Consolidate Cases as follows: I . While it is admitted that both of the above-referenced civil actions sought to be consolidated arise from the same transaction or occurrence, it is specifically denied that Answering Defendants were negligent. To the contrary, at all relevant times, Answering Defendants met or exceeded the standard of care and at no time caused or contributed to the injuries as alleged. 2. Admitted. 3. Admitted. 4. Admitted. 5. While it is admitted that Plaintiffs filed a second medical negligence action by way of Writ of Summons against various Defendants on December 15, 2005 in the Cumberland County Court of Common Pleas, Answering Defendants do not have information as to the basis for the filing of said Writ of Summons. 6. Admitted. 7. Admitted. 8. Admitted. 9. Admitted. 10. Pa.R.C.P. No. 213(a) speaks for itself, 11. The Lohmiller v. Weidenbaueh opinion found at 448 A.2d 583, 587 (Pa. Super. 1982) speaks for itself. 12. Admitted. 13. Admitted, 14. Admitted. 2 WHEREFORE, Answering Defendants respectfully request that this Honorable Court grant Plaintiffs' Motion to Consolidate the above-referenced civil actions. Respectfully submitted, FOULKROD ELLIS PROFESSIONAL CORPORATION By: ; , t a J) - Michael C. Mongie ]o, squire Attorney I.D. No. 87532 Date: February Z'? , 2006 I HEREBY CERTIFY that a true aAd correct copy of the foregoing document was served rAL) upon all counsel of record thid--5 day of February, 2006, by depositing said copy in the United States Mail at Camp Hill, Pennsylvania, postage prepaid, first class delivery, and addressed as follows: Aaron J. Freiwald, Esquire Thomas M. Chairs, Esquire Layser & Freiwald, P.C. Dickie, McCamey & Chilcote 1500 Walnut Street, 181h Floor 1200 Camp Hill Bypass - Suite 202 Philadelphia, PA 19102 Camp Hill, PA 17011 James M. Prahler, Esquire Peter J. Curry, Esquire Margolis Edelstein Thomas Thomas & Hafer, LLP The Curtis Center, 41h Floor 3400 Bath Pike - Suite 302 Independence Square West Bethlehem, PA 18017 Philadelphia, PA 19106-3304 FOULKROD ELLIS PROFESSIONAL CORPORATION By: Gl?- O Cheryl A. aro alo, Legal Secret ry ?, A ft)u 'W t0U'Y NunFiEU 1U PLEAD to 141 ENCLOSED PLrAWNC a97kIN F4:,'h1j ;eO) O.AYS MM Si.RVICiE Nba_Ui (E7fj A OFEAULT JUVWANi WILL 6E ENTERED ,VC.AW1let1V; Attorney for Defendant, Dialysis Corporation of America COURT OF COMMON PLEAS CUMBERLAND COUNTY NO. 05-6393 ANSWER OF DEFENDANT, DIALYSIS CORPORATION OF AMERICA TO PLAINTIFF'S AMENDED COMPLAINT WITH NEW MATTER The Defendant, Dialysis Corporation of America, by its attorneys, MARGOLIS EDELSTEIN BY: JAMES M. PRAHLER, ESQUIRE Identification No. 54703 The Curtis Center, 4th Floor 601 Walnut Street Philadelphia, PA 19106 215-922-1100 JANET ARONSON, Administrator :)f the Estate of STEPHEN J. 4RONSON, Deceased V. BARBARA LITTLE, N.P., THOMAS W. ALDOUS, M.D. AND DIALYSIS CORPORATION OF Margolis Edelstein, does herein make and provide the following Answer to the Plaintiff's Complaint. 1. Admitted based upon information and belief. 2. Admitted based upon information and belief. 3. Admitted based upon information and belief. 4. The answering Defendant makes no reply to the allegations contained in this Paragraph as they are directed to another party. 5. The answering Defendant makes no reply to the allegations contained in this Paragraph as they are directed to another party. 6. The Defendant, Dialysis Corporation of America is a Corporation under the laws of the Commonwealth of Pennsylvania. The allegations in this paragraph are denied. Dialysis Corporation of did not own or operate the facility located at 27 Miller Street, Lemoyne, nnsylvania 17043. This facility was owned and operated by Dialysis of America-Lemoyne. Dialysis Corporation of America did not professional care at any time. 7. The Answering Defendant makes no reply to the allegations in this paragraph as they are directed to another party. 8. The Answering Defendant makes no reply to the allegations in this paragraph as they are directed to another party. 9. Denied. Dialysis Corporation of America did not engage in medical and treatment for Stephen Aronson at any time. 10.-64. The answering Defendant denies the allegations contained in paragraphs pursuant to PA.R.C.P. 1029(e). FIRST CAUSE OF ACTION-WRONGFUL DEATH ACT 65. The Answering Defendant repeats its answers to the allegations in paragraphs 1 through 64 of the Complaint as if fully set forth 66.-71. After reasonable investigation, the answering Defendant is out information adequate to form a belief as to the truth of the allegations in these paragraphs and they are therefore denied. WHEREFORE, the defendant, Dialysis Corporation of America prays Judgment be entered in its favor and against the plaintiff. SECOND CAUSE OF ACTION-SURVIVAL ACTION 72. The answering Defendant repeats its answers to the allegations ned in Paragraphs 1 through 71 of the Plaintiff's Complaint as if fully set herein. 73-78. After reasonable investigation, the Answering Defendant is out information adequate to form a belief as to the truth of the allegations in these paragraphs and they are therefore denied. WHEREFORE, the defendant, Dialysis Corporation of America prays Judgment be entered in its favor and against the plaintiff. COUNT I - NEGLIGENCE 79. The answering defendant repeats its answers to the allegations ned in paragraphs 1 through 78 as if fully set forth herein. 80. Denied pursuant to PA.R.C.P. 1029(e). 81. Denied pursuant to PA.R.C.P. 1029(e). COUNT II - NEGLIGENCE 82. The answering Defendant repeats its answers to the allegations in paragraphs 1 through 81 of the Complaint as if fully set forth 83. The allegations contained in this paragraph are denied pursuant to A. R.C.P. 1029(e). 84. The allegations contained in this paragraph are denied pursuant to R.C.P. 1029(e). COUNT III-NEGLIGENCE 85. The answering defendant repeats its answers to the allegations mtained in Paragraphs 1 through 84 as if fully set forth herein. 86. (a)-Q) - The answering defendant, Dialysis Corporation of America 3nies the allegations contained in this paragraph and all subparagraphs (a) rough 0) thereof pursuant to Pa.R.C.P. 1029(e). Further, Dialysis Corporation America did not provide medical care and treatment to Stephen Aronson and smissal of this action will be sought pursuant to Pa. R.C.P. 1036, 40 P.S. action 1301.827-A. 87. Denied pursuant to Pa. R.C.P. 1029(e). WHEREFORE, the defendant, Dialysis Corporation of America prays at Judgment be entered in its favor and against the plaintiff. NEW MATTER 1. Plaintiff's Complaint against Answering Defendant is barred in ole or in part by the applicable statute of limitations. 2. The defenses of assumption of the risk, comparative negligence 1 contributory negligence are raised and preserved under and pursuant to .R.C.P. 1030(b). 3. Plaintiff has failed to state a cause of action upon which relief may granted. 4. Answering Defendant was not negligent and acted within the ropriate standard of care. 5. Plaintiff's claimed injuries are the result of a condition or nditions which could not with the exercise of due care be corrected. 6. Any acts or omissions of Answering Defendant alleged to nstitute negligence were not substantial factors in the injuries and damages 7. Plaintiff's alleged injuries and damages were not proximately sed by any acts or omissions of Answering Defendant. 8. By way of further New Matter, Answering Defendant avers that it the acts or omissions of other individuals and/or entities, including Plaintiff self, which, in fact, constituted actual, intervening or superceding causes of injuries and damages Plaintiff has alleged. 9. Upon information and belief, Plaintiff has failed to mitigate her i damages. 10. Plaintiff may have already entered into a release with other ties and/or Defendants, which has the effect of discharging or reducing the ility of Answering Defendant. 11. Any award given to Plaintiff shall be offset by any public collateral rce of compensation or benefits pursuant to Section 602 of the Health Care vices Malpractice Act. 12. Section 606 of the Health Care Services Malpractice Act provides t, in the absence of a special contract in writing, a health care provider is iher a warrantor, nor a guarantor of a cure, and thus, Section 606 bars intiff's claims in this case. 13. By way of further New Matter, and in the alternative, Answering avers that Plaintiff's causes of action are barred and/or limited by applicable provisions of the Pennsylvania Medical Care Availability and of Error Act, 40 P.S. § 1303.102, et seq., including, but not limited to, 105, 504, 505, 507, 508, 509, 510 of the Act. 14. Dialysis Corporation of America did not provide medical care and to Stephen Aronson and dismissal of this action is proper pursuant to R.C.P. 1036, 40 P.S. Section 1301.827-A. WHEREFORE, Answering Defendant demand that Plaintiffs Complaint dismissed with prejudice and judgment entered in its favor. MARGOLIS EDEL_STEIN BY: JAMES M. PRAHLER, ESQUIRE Attorney for Defendant, Dialysis Corporation of America V E R I F I C A T I O N The undersigned, having read the attached pleading, erifies that the within pleading is based on information urnished to counsel, which information has been gathered by ounsel in the course of this lawsuit. The language of the leading is that of counsel and not of signer. Signer erifies that he has read the within pleading and that it is rue and correct to the best of Signer's knowledge, nformation and belief. To the extent that the contents of he pleadings are that of counsel, verifier has relied upon ounsel in taking this verification. This verification is ade subject to the penalties of 18 Pa. C.S. Section 4904 elating to unsworn falsification to authorities. 7 t--??L I) Lkd1 J ANNE ZIMME 1;??_ DIALYSIS CORPORATION 095:AMERICA . ?)Auh ? LAYSER & FREIWALD, P.C. By: Aaron J. Freiwald, Esquire aif(n Iayserfreiwald.com Attorney I.D. No. 7.8028 1500 Walnut Street, 18' Floor Philadelphia, PA 19102 (215) 875-8000 Attorney for Plaintiffs JANET ARONSON, Executrix of the Estate of STEPHEN J. ARONSON deceased Plaintiffs V. BARBARA A. LITTLE, N.P., et al. COURT OF COMMON PLEAS OF CUMBERLAND COUNTY NO. 05-6393 PLAINTIFFS' REPLY TO NEW MATTER OF DEFENDANT DIALYSIS CORPORATION OF AMERICA TO THE AMENDED COMPLAINT 1. Denied. This paragraph states a conclusion of law to which no response is required. 2. Denied. This paragraph states a conclusion of law to which no response is required. 3. Denied. This paragraph states a conclusion of law to which no response is required. 4. Denied. This paragraph states a conclusion of law to which no response is required. 5. Denied. This paragraph states a conclusion of law to which no response is required. 6. Denied. This paragraph states a conclusion of law to which no response is required. 7. Denied. This paragraph states a conclusion of law to which no response is required. 8. Denied. This paragraph states a conclusion of law to which no response is required. 9. Denied. This paragraph states a conclusion of law to which no response is required. 10. Denied. This paragraph states a conclusion of law to which no response is required. 11. Denied. This paragraph states a conclusion of law to which no response is required. 12. Denied. This paragraph states a conclusion of law to which no response is required. 13. Denied. This paragraph states a conclusion of law to which no response is required. 14, Denied. This paragraph states a conclusion of law to which no response is required. LAYSER & FREMALD, P.C. By: AAR J. FREIWALD, ESQUIRE Counsel for Plaintiffs 1500 Walnut Street, 18`r Floor Philadelphia, PA 19102 (215) 875-8000 DATED: ??? ?d,) VERIFICATION I, AARON J. FREIWALD, ESQUIRE, hereby verify that the facts set forth in the foregoing Plaintiffs' Reply to New Matter are true and correct to the best of my knowledge, information and belief. The undersigned understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. 3011, AARON J. FREIWALD, ESQUIRE DATED: '?j ((?(y? CERTIFICATE OF SERVICE I, AARON J. FREIWALD, ESQUIRE, hereby certify that service of a true and correct copy of the attached Plaintiffs' Reply to New Matter of Defendant Dialysis Corporation of America was served upon opposing counsel on this date, via United States First Class Mail, Postage Prepaid, as follows: Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote 1200 Camp Hill Bypass Suite 205 Camp Hill, PA 17011-3700 Michael C. Mongiello, Esquire Foulkrod Ellis 2010 Market Street Camp Hill, PA 17011 James Prahler, Esquire Margolis Edelstein Independence Square West 6th & Walnut Streets, 4th Floor Philadelphia, PA 19103 Peter J. Curry, Esquire Thomas, Thomas & Hafer 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 LAYSER & FREIWALD, P.C. By: AARON J. FREIWALD, ESQUIRE DATED: ,; _, FOULKROD ELLIS Professional Corporation 2010 Market Street Camp Hill, PA 17011 Phone: (717) 909-7006 Attorney for Defendant: Fax- (717) 909-6955 Barbara A. Little. N.P. JANET ARONSON, as Administratrix of the IN THE COURT OF COMMON PLEAS Estate of STEPHEN J. ARONSON, CUMBERLAND COUNTY, PENNSYLVANIA Deceased, V. CIVIL ACTION - LAW BARBARA A. LITTLE, N.P., THOMAS W. ALDOUS, M.D. and DIALYSIS CORPORATION OF AMERICA, Defendants JURY TRIAL DEMANDED PRAECIPE TO FILE STIPULATION OF COUNSEL STRIKING CERTAIN PARAGRAPHS OF PLAINTIFF'S COMPLAINT AS TO BARBARA A. LITTLE, N.P. TO: PROTHONOTARY Kindly file of record the attached Stipulation of Counsel. Plaintiff : NO. 05-6393 FOULKROD ELLIS PROFESSIONAL CORPORATION A l? By: Michael C. ongiello, Esquire Attorney I.D. No. 87532 Date: March Z() , 2006 JANET ARONSON, as Administratrix of the Estate of STEPHEN J. ARONSON, Deceased, Plaintiff V. BARBARA A. LITTLE, N.P., THOMAS W ALDOUS, M.D. and DIALYSIS CORPORATION OF AMERICA, Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 05-6393 CIVIL ACTION - LAW JURY TRIAL DEMANDED STIPULATION OF COUNSEL Plaintiff, Janet Aronson, as Administratrix of the Estate of Stephen J. Aronson, Deceased, by and through her counsel, Aaron J. Freiwald, Esquire; and Defendant, Barbara A. Little, N.P., by and through her counsel, Michael C. Mongiello, Esquire, hereby stipulate and agree as follows: Counsel executing this Stipulation hereby represent and warrant that they are authorized to do so by their respective clients. 2. Allegations found at subparagraphs 80(a), (b), (c), (d), (e), (g) and (h) are stricken from Plaintiff's Amended Complaint with prejudice. 3. This Stipulation may be executed in counterparts and shall be considered effective when signed by all counsel, even though signed on separate signature pages, and may be filed of record. Facsimile or photocopy reproduction of signatures shall have the effect of original signatures. IN WITNESS WHEREOF, the parties, by their counsel, have caused this Stipulation to be executed and intend to be legally bound thereby. LAY & FREIWALD, P.C. By: Aaron J. Freiwald, Esquire 1500 Walnut Street - 18`h Floor Philadelphia, PA 19102 Attorney for Plaintiff FOULKROD ELLIS PROFESSIONAL CORPORATION /g ( iih By: Michael C. ongiello, Esquire 2010 Market Street Camp Hill, PA 17011 Attorney for Defendant, Barbara A. Little, N.P. Date: Date: ? 1 61 b I, Cheryl A. Garofalo, an employee of the law firm of Foulkrod Ellis, P.C., hereby certify that a true d c rrect copy of the foregoing document was served upon all counsel of record this day of March, 2006, by depositing said copy in the United States Mail at Camp Hill, Pennsylvania, postage prepaid, first class delivery, and addressed as follows: Aaron J. Freiwald, Esquire Layser & Freiwald, P.C. 1500 Walnut Street, 18th Floor Philadelphia, PA 19102 Attorney for Plaintiff Francis E. Marshall, Jr., Esquire Thomas M. Chairs, Esquire Marcelle M. Theis, Esquire Dickie McCamey & Chilcote, P.C. 1200 Camp Hill Bypass - Suite 205 Camp Hill, PA 17011 Attorneys for Defendant, Thomas W. Aldous, M. D. Attorney for Dialysis Corporation ofAmerica James M. Prahler, Esquire Margolis Edelstein The Curtis Center, 41h Floor Independence Square West Philadelphia, PA 19106-3104 FOULKROD ELLIS CORPORATION Cheryl I LAYSER & FREINVALD, P.C. By: Aaron J. Freiwald, Esquire ajf(c Jayserfreiwald.com Attorney I.D. No. 78028 1500 Walnut Street, 18' Floor Philadelphia, PA 19102 (2) 5)875-8000 Attorney for Plaintiffs JANET ARONSON, Executrix of the Estate of STEPHEN J. ARONSON, deceased Plaintiffs V. COURT OF COMMON PLEAS OF CUMBERLAND COUNTY JONATHAN R. DIAMOND, M.D., et al. NO. 06-111 JANET ARONSON, Executrix of the Estate of STEPHEN J. ARONSON deceased Plaintiffs V. BARBARA A. LITTLE, N.P., et al. COURT OF COMMON PLEAS OF CUMBERLAND COUNTY NO. 05-6393 ORDER {d` AND NOW, this 1. 8 day of M aetc1 , 2006, upon consideration of Plaintiffs' Motion to Consolidate Cases, and any response thereto, it is here by ORDERED that the above captioned cases are consolidated under docket number 06-111. BY THE COURT: rL? n a. R CA MARGOLIS, EDELSTEIN BY: JAMES M. PRAHLER, ESQUIRE Identification No. 54703 The Curtis Center, 4th Floor Independence Square West Philadelphia, PA 19106 (215) 931-5860 JANET ARONSON, Administratrix of the Estate of STEPHEN J. ARONSON, Deceased V. BARBARA LITTLE, N.P., THOMAS W. ALDOUS, M.D. AND DIALYSIS CORPORATION OF AMERICA Attorney for Defendant, Dialysis Corporation of America COURT OF COMMON PLEAS CUMBERLAND COUNTY NO. 05-6393 JANET ARONSON, Administratrix of COURT OF COMMON PLEAS the Estate of STEPHEN J. CUMBERLAND COUNTY ARONSON, Deceased V. JONATHAN A. DIAMOND. M.D., et al NO. 06-111 REQUEST FOR PLAINTIFF EXPERT REPORTS TO: Aaron J. Freiwald, Esquire Layser & Freiwald 1500 Walnut Street, 18`h Floor Philadelphia, PA 19102 Pursuant to Pa. R.C.P. 1042.28(b), you are requested with 180 days of service of this Request, to furnish to me, as counsel for Defendant, Dialysis Corporation of America-Lemoyne and Dialysis Corporation of America, expert reports summarizing the expert testimony that you will author to support the claims of professional negligence that you have made against the above defendants. Under the Pa. Rules of Civil Procedure, you are required to serve copies of all expert reports on other parties. MAR LIS EDELSTEIN BY: if9G"¢sf JAMES M. PRAHLER, ESQUIRE Attorney for Defendant DATED: July 11, 2006 ,/ t CERTIFICATE OF SERVICE I hereby certify that a true and correct copy of the foregoing Request for Plaintiff's Expert Reports was served upon all counsel of record on the 11t" day of July, 2006 by U.S. Mail, first class , postage prepaid as follows: Aaron J. Freiwald, Esquire Layser & Freiwald 1500 Walnut Street, 18`" Floor Philadelphia, PA 19102 Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote 1200 Camp Hill Bypass, Suite 202 Camp Hill, PA 17011 Peter J. Curry, Esquire Thomas Thomas & Hafer, LLP 3400 Bath Pike, Suite 302 Bethlehem, PA 18017 Michael C. Mongiello, Esquire Foulkrod Ellis 2010 Market Street Camp Hill, PA 17011 _ i 0 AMES M. PRAHLER, ESQUIRE J •n IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA JANET ARONSON, Administratrix of the Estate of STEPHEN J. ARONSON, : deceased Plaintiffs, V. : BARBARA A. LITTLE, N.P., ET AL. COURT OF COMMON PLEAS OF CUMBERLAND COUNTY NO.: 05-6393 Defendants JURY TRIAL DEMANDED PLAINTIFF'S RESPONSE IN OPPOSITION TO MOTION FOR SUMMARY JUDGMENT OF DEFENDANT HERBERT I. SOLLER M.D. Plaintiff, Janet Aronson, Administratix of the Estate of Stephen J. Aronson, deceased, by and through her attorneys, Layser & Freiwald, P.C., oppose the Motion for Summary Judgment and responds as follows: 1-6. Admitted. 7-9. Denied as stated. The averments contained in these paragraphs are denied to the extent that they differ from, or contrary to Plaintiff's Second Amended Complaint. Further, the Second Amended Complaint is a document in writing that speaks for itself. 10. Admitted. 11. Denied as stated. The averments contained in this paragraph are denied to the extent that they differ from, or contrary to Plaintiff's Second Amended Complaint. Further, the Second Amended Complaint is a document in writing that speaks for itself. 12-14. Admitted. 15-17. Denied as stated. The averments contained in this paragraph are denied to the extent that they differ from, or contrary to Dr. Silberzweig's expert report. Further, Dr. Silberzweig's expert report is a document in writing that speaks for itself. 17. Admitted. 18-20. Denied as stated. The averments contained in this paragraph are denied to the extent that they differ from, or contrary to Plaintiffs Second Amended Complaint. Further, the Second Amended Complaint is a document in writing that speaks for itself 21. Denied. 22. Denied. 23. Denied. 24. Denied. Dr. Silberzweig's report makes clear that Dr. Soller as medical director failed to ensure that the staff was appropriately trained to make the assessment that there was an abnormality in the access. Had Dr. Soller enforced the policies and procedures of the dialysis center the staff would have been given the requisite training and supervision to make the assessment that there was an abnormality in the access. By failing to enforce the appropriate policies and procedures Dr. Soller allowed the Dialysis center and its staff to fall into a state of incompetence. 25-29. Denied. The averments contained in these paragraphs are conclusions of law. 30. Denied. 31. Denied. 32. Denied. The averments contained in this paragraph are conclusion of law. 33-34. Denied. The averments contained in this paragraph are conclusion of law. 2 7 WHEREFORE, Plaintiff Janet Aronson respectfully request that this Honorable Court deny Defendant Herbert I. Soller, M.D.'s Motion for Summary Judgment. Respectfully Submitted, LAYS" &,'RE.-LV;?.C. By: AAFeys J. ?IWALD GLE A. ELLIS Atto for Plaintiff Dated: t0 Z lo 8 3 C> --a `rt ? _>.- y' ?;. j ;-r IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA JANET ARONSON, Administratrix of the Estate of STEPHEN J. ARONSON, deceased COURT OF COMMON PLEAS OF CUMBERLAND COUNTY Plaintiffs, V. BARBARA A. LITTLE, N.P., ET AL NO.: 05-6393 Defendants PLAINTIFF'S RESPONSE TO DEFENDANTS' MOTION IN LIMINE OF JONATHAN R. DIAMOND, M.D., ANDREA J. SHAER, M.D., BARBARA A. LITTLE. N.P. AND HERSHEY KIDNEY SPECIALISTS Plaintiff Janet Aronson, Administratrix of the Estate of Stephen J. Aronson, deceased, by and through her attorneys, Layser & Freiwald, P.C., hereby responds to the Motion in Limine of Defendants, Jonathan R. Diamond, M.D., Andrea J. Shaer, M.D., Barbara A. Little, N.P. and Hershey Kidney Specialists, as follows: 1. Admitted. 2. Denied as stated. Dr. Silberzweig's report is a document in writing and as such speaks for itself. It is admitted that Dr. Silberzweig opines on the care rendered by Nurse Little. 3. Denied as a legal conclusion. By way of further response, Pennsylvania Professional Nursing Law, 63 P.S. §211 et seq., outlines the definition of nursing responsibilities as: "Diagnosing and treating human responses to actual or potential health problems through such services as case finding, health counseling, and provision of care supportive to or 2 restorative of life and well-being and medical regimen as prescribed by a licensed physician" See 63 P. S. §211(1) (Emphasis added) The prohibition set forth by the §211(1) is specific as to medical diagnoses. The statute defines nursing as diagnosing "human responses to actual or potential health problems."See 63 P.S. §211(1). Dr. Silberzweig's report is clear in that he is not suggesting Nurse Little failed to make a medical diagnosis but instead is opining the she failed to properly and promptly assess the patient and diagnosis his symptoms (i.e. his "human response") to his actual health problem, which was an infection. WHEREFORE, Plaintiff, Janet Aronson, Administratrix of the Estate of Stephen J. Aronson, deceased, respectfully requests that this Honorable Court enter the attached Order. 4. Admitted. 5. Admitted. 6. Denied as stated. Dr. Silberzweig's report is a document in writing and as such speaks for itself. It is admitted that Dr. Silberzweig opines on the care rendered by Drs. Diamond and Shaer. 7. Admitted. 8. Denied as stated. Dr. Mehlman's CV is a document in writing and as such speaks for itself. It is admitted that Dr. Mehlman is not a nephrologist. 9. Denied as stated. Dr. Mehlman's report is a document in writing and as such speaks for itself. 10. Admitted. 11. Denied as stated. Dr. Griffiths's CV is a document in writing and as such speaks for itself. It is admitted that Dr. Griffiths is not a nephrologist. 3 12. Denied as a legal conclusion. By way of further response, what defendant calls Dr. Melhman's "opinions" are simply facts. 13. Denied as a legal conclusion. WHEREFORE, Plaintiff, Janet Aronson, Administratrix of the Estate of Stephen J. Aronson, deceased, respectfully requests that this Honorable Court enter the attached Order. FREIW)KYO, P By: DATED: 6 3 1 0 6 AA O J. FREIWALD, ESQ G . ELLIS, ESQUIRE A ornevs for Plaintiff 4 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA JANET ARONSON, Administratrix of the Estate of STEPHEN J. ARONSON, deceased Plaintiffs, V. BARBARA A. LITTLE, N.P., ET AL. COURT OF COMMON PLEAS OF CUMBERLAND COUNTY NO.: 05-6393 Defendants MEMORANDUM OF LAW IN SUPPORT OF PLAINTIFF'S RESPONSE TO DEFENDANTS' MOTION IN LIMINE OF JONATHAN R. DIAMOND, M.D., ANDREA J. SHAER, M.D., BARBARA A. LITTLE, N.P. AND HERSHEY KIDNEY SPECIALISTS 1. FACTUAL HISTORY Plaintiff Stephen J. Aronson had a history of diabetes and kidney failure. In 2003, Mr. Aronson had placed a dialysis shunt in his left arm in anticipation of dialysis. Mr. Aronson underwent his first dialysis treatment on January 24, 2004 at Dialysis Corp., in Lemoyne, Pennsylvania. He was not seen or evaluated or counseled by a physician during his time at dialysis on January 24, 2004. On January 26, 2004 at approximately 5:15 p.m., Mr. Aronson presented to the emergency department of Holy Spirit Hospital complaining of shortness of breath lasting several hours. Mr. Aronson also complained on arrival to the emergency department of a diminished level of consciousness and decreased memory for the previous 24 hours, as well as right arm soreness. On triage, it was noted that Mr. Aronson had an elevated temperature to 100.4, blood pressure pf 141/55, pulse of 92, respirations of 18, and a pulse ox of only 87 percent on room air. 5 The triage nurse also noted that Mr. Aronson was complaining of difficulty swallowing and of bleeding from the dialysis shunt in his right arm. Mr. Aronson's treating nephrologists Dr. Diamond, was consulted at approximately 8:35 p.m. by telephone, but Dr. Diamond did not come to see his patient in the hospital. No antibiotics were given in the emergency department. At approximately 11:05 p.m., Mr. Aronson was discharged to home from the emergency department with instructions to follow up with his scheduled dialysis appointment the following day. On January 27, 2004, Mr. Aronson presented for dialysis at the Dialysis Corp. in Lemoyne. During Mr. Aronson's dialysis treatment, a call was received from Dr. Diamond notifying the dialysis center that Mr. Aronson's blood cultures taken the previous evening at Holy Spirit Hospital were positive. During dialysis on January 27, 2004, Mr. Aronson was found to be very lethargic but with less shortness of breath. During dialysis on January 27, 2004, blood was drawn for a CBC. Mr. Aronson was not seen or evaluated or counseled by any physician at the dialysis session on January 27, 2004. Blood culture results from January 27, 2004 confirmed the culture results from January 26, 2004 at Holy Spirit Hospital, which had showed the presence of bacteria in Mr. Aronson's blood. Mr. Aronson died on February 24, 2004 of complications of overwhelming sepsis. 6 II. QUESTION PRESENTED 1. Should Dr. Silberzweig be precluded from testifying as to Nurse Little's negligence as outlined in his report? Suggested Answer: No. 2. Should Drs. Mehlman and Griffths be precluded from testifying as to Drs. Diamond's and Shaer's negligence as outlined in their reports? Suggested Answer: No. III. ARGUMENT A. Dr. Silberzweig's report does not fault Nurse Little for failing to make a medical diagnosis. Dr. Silberzweig's report states that Nurse Little failed to properly evaluate Mr. Aronson on January 27, 2004 while he was undergoing dialysis treatment. See Def. Exhbit 1. In specific, Dr. Silberzweig opines that she failed to "recognize that the access was the likely source of Mr. Aronson's infection" and that she "failed to recognize the serious nature his symptoms." Id. As a result, Dr. Silberzweig opines that Nurse Little contributed to the delay in diagnosising and treating bacteremia. Id. Neither of these opinions rise to the level of a medical diagnosis even using defendant's proposed definition. B. Drs. Mehlman's and GriMhs's reports are not cumulative nor do they opine beyond their expertise under the MCARE Act. In their motion, defendants complain that Dr. Mehlman, Plaintiffs' emergency medical expert opines on the standard of care of a nephrologist. A review of his expert report shows that defendants are simply wrong. What defendants want the Court to consider opinions are simply facts. It is a fact that "Dr. Shaer, the nephrologist, was notified of the blood cultures positive from dialysis." See Def. Ex. 5. It is a fact that "Dr. Shaer ...was also aware of the patient's 7 condition and positive blood cultures, but did nothing to admit him and get treatment going immediately." Id. It is completely appropriate for Dr. Mehlman to have mentioned and considered all of the facts, even those that defendant now finds inconvenient. Regarding Dr. Griffths, while it is true that he is not nephrologist, he is an infectious disease expert. Considering that Drs. Diamond and Shaer were treating Mr. Aronson's infection it is appropriate to call Dr. Griffths regarding defendant doctors' treatment of said infection. In Johnson v. Romv, 1996 LEXIS 2116 (Pa. Super. 1996), the Superior Court of Pennsylvania held that it was reversible error to preclude the expert testimony of separate physicians - with differing sub-specialties - from testifying as to the standard of care against a single defendant physician, where each field of proposed expert testimony was involved in the patient's treatment. In Johnson, the plaintiff sued the defendant, Maurice Romy, M.D., an orthopedic surgeon, for medical malpractice arising out of an alleged misdiagnosis and subsequent injection and surgical laminectomy to treat plaintiffs back pain. At trial, plaintiff intended to call four separate medical experts to opine as to the standard of care against Dr. Romy - (1) an orthopedic surgeon, (2) a neurosurgeon (who was also plaintiff's treating physician), (3) a neuro-radiologist, and (4) another treating physician of the plaintiff. The Court of Common Pleas of Philadelphia County sustained the defendant's objection to the use of four experts on the grounds that testimony from four experts would be, in the court's view, "cumulative" ruling that the plaintiff was to choose two out of the four experts. The Superior Court in Johnson reversed and granted a new trial on the sole basis that the trial court committed error and abused its discretion in its preclusion of plaintiff's experts as "cumulative." The Superior Court reasoned that it is entirely proper to call multiple experts - with different fields of expertise - to testify as to the standard of care against a single defendant, in a situation involving separate, but overlapping fields, of medicine. In finding error, the Superior Court stated: "Although we recognize that some of the testimony of the precluded experts has the potential to overlap some of the opinions proffered by the experts that testified, we cannot ignore the reality that each expert was prepared to testify specifically as to his or her area of expertise. Appellee cannot be rewarded (nor should appellant be punished) for the fact that he treated Appellant in three separate capacities. By treating Appellant in this manner Appellee presented the opportunity or necessity to call different experts. Thus, limiting the use of Appellant's expert witnesses was an abuse of discretion in the circumstances presented. For this reason we must reverse and remand for a new trial." In the recent case of Herbert v. Parkview Hospital, 854 A.2d 1285, 1294 (Pa. Super. 2004), the Superior Court of Pennsylvania further clarified the admissibility of expert testimony and the permissibility to call expert physicians (under the MCARE Act) with a different sub-speciality from that of the defendant against whom the experts testimony is offered. The Herbert Court held that expert physicians may testify against defendant physicians in medical malpractice cases under § 1303.512(c)(2) of the MCARE Act, so long as their expertise has [a similar standard of care.] See Herbert, 854 A.2d at 1294, citing Callari v. Rosenwasser, 63 Pa. D&C 4th 366, 378 (Philadelphia C. P. 2003) (ruling that where a neurosurgeon, rendering post-operative care, discovers and treats an infection, MCARE § 1303.512(c) permits the testimony of an infectious disease expert against that neurosurgeon). In light of the above, it is clear that Plaintiff is entitled to call Dr. Griffths, an infection disease expert, with regards to Drs. Diamond's and Shaer's treatment of Mr. Aronson's infection. Finally, the opinions of the Drs. Griffiths and Mehlman are not cumulative. First, beyond making the bald statement that the opinions "all... essentially deal with [a] failure to more aggressively treat Mr. Aronson," defendant does not point to any specific part of the reports that 9 actual overlap. Second, pursuant to Pa.R.C.P. No. 223, the Trial Court is entitled to make and enforce rules and orders "[l]imiting the number of witnesses whose testimony is similar or cumulative." However, the Pennsylvania Courts have long recognized that the trial court may refuse to admit testimony as cumulative only when the witnesses statements involve essentially the same facts and issues that another expert witness' testimony addressed. Lewis v. Mellor, 393 A.2d 941, 949 (Pa. Super. 1978). Here, the two experts in question are opining on different aspects of Mr. Aronson's treatment by various defendant doctors of the same speciality. Dr. Mehiman opines on the treatment provided by the emergency room doctors and Dr. Griffiths opines on the treatment of Mr. Aronson's infection and also on causation, namely the link between defendants' negligence and Mr. Aronson's developing bacteremia.' Thus, while the experts may ultimately lead to the same conclusion that the doctors were negligent for failing to treat Mr. Aronson's infection their specific opines are properly confined to their expertise and as such are not cumulative. See Johnson v. Romy, 1996 LEXIS 2116 (Pa. Super. 1996) 'Defendants do not challenge Dr. Griffiths in terms of his causation opinions. 10 IV. CONCLUSION For the reasons set forth above, Plaintiff respectfully requests this Honorable Court enter the attached proposed Order denying the Defendants' Motion in Limine of Defendants, Jonathan R. Diamond, M.D., Andrea J. Shaer, M.D., Barbara A. Little, N.P. and Hershey Kidney Specialists. LAYMF/$ YREJ AIAD. P, By: DATED: 10)3110 % IWALD, ESQUIRE A. ELLIS, ESQUIRE s for Plaintiff 11 VERIFICATION I, GLENN A. ELLIS, attorney for plaintiff in the foregoing action, hereby verify that the statements made in the foregoing Response to Defendant's Motion of Defendants, Jonathan R. Diamond, M.D., Andrea J. Shaer, M.D., Barbara A. Little, N.P. and Hershey Kidney Specialists are true and correct to the best of my knowledge, information and/or belief. I understand that false statements hereunder made are subject to the penalties of 18 Pa. C.S. §4904 relating to unsworn falsifications to authorities. , ESQUIRE DATED: l p S l 9 °? 12 CERTIFICATE OF SERVICE I, GLENN A. ELLIS, ESQUIRE, hereby certify that service of a true and correct copy of Plaintiff's Response to Defendant's Motion in Limine of Defendants, Jonathan R. Diamond, M.D., Andrea J. Shaer, M.D., Barbara A. Little, N.P. and Hershey Kidney Specialists was served upon opposing counsel on this date, via Overnight Mail, as follows: Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote 1200 Camp Hill Bypass Suite 202 Camp Hill, PA 17011-3700 Michael C. Mongiello, Esquire Foulkrod Ellis 2010 Market Street Camp Hill, PA 17011 James Prahler, Esquire Margolis Edelstein Independence Square West 6th & Walnut Streets, 4th Floor Philadelphia, PA 19103 By: DATED: 10/;1/01 Peter J. Curry, Esquire Thomas, Thomas & Hafer 3400 Bath Pike, Suite 302 Bethlehem, PA 18017 P..-i f _.?',: i .. i E 11 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA JANET ARONSON, Administratrix of the Estate of STEPHEN J. ARONSON, COURT OF COMMON PLEAS deceased OF CUMBERLAND COUNTY Plaintiffs, v. BARBARA A. LITTLE, N.P., ET AL. NO.: 05-6393 Defendants ENTRY OF APPEARANCE Kindly enter my appearance on behalf of Plaintiff with regard to the above-captioned matter. R L B (Date: j'/n /at CERTIFICATE OF SERVICE I, GLENN A. ELLIS, ESQUIRE, hereby certify that service of a true and correct copy of the Entry of Appearance was served upon opposing counsel on this date, via United States First Class Mail, Postage Prepaid, as follows: Michael C. Mongiello, Esquire Foulkrod Ellis 2010 Market Street Camp Hill, PA 17011 Peter J. Curry, Esquire Thomas, Thomas & Hafer 3400 Bath Pike, Suite 302 Bethlehem, PA 18017 By: DATED: ?? ?? Q 0 ?? ? ? ?;? ?? r' ?' 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